Related Experiment Video
Updated: May 6, 2026
The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
Association of cirrhosis severity with outcomes after hip fracture repairs: A propensity-score matched analysis using
Osamu Hamada1, Takahiko Tsutsumi1, Ayako Tsunemitsu1
1Department of General Internal Medicine, Takatsuki General Hospital, Osaka, Japan; Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Insights
Hip fracture surgery outcomes worsen with cirrhosis severity. Patients with Child-Pugh class C cirrhosis face significantly higher in-hospital mortality compared to class B, necessitating careful risk assessment.
Area of Science:
- Orthopedic Surgery
- Hepatology
- Public Health
Background:
- Advanced cirrhosis increases surgical mortality risk, but its impact on hip fracture patients is not well understood.
- Hip fractures are common in elderly populations, often with comorbidities like cirrhosis.
Purpose of the Study:
- To investigate the association between cirrhosis severity (Child-Pugh classes A, B, C) and postoperative outcomes in hip fracture patients.
- To compare in-hospital mortality, length of stay, hospitalization fees, readmission, and complication rates across different cirrhosis severity groups.
Main Methods:
- Analysis of a large Japanese nationwide administrative database (Diagnosis Procedure Combination Database) from July 2010 to March 2021.
- Inclusion of 833,648 patients with hip fractures undergoing surgery.
- 1:1 propensity-score matching comparing non-cirrhosis, Child-Pugh A, B, and C groups.
Main Results:
- In-hospital mortality was similar between non-cirrhosis and Child-Pugh A groups.
- Mortality significantly increased from Child-Pugh A to B (5.9% vs 1.5%) and further from B to C (28.4% vs 6.3%).
- Higher Child-Pugh classes correlated with longer hospital stays, increased fees, and more complications.
Conclusions:
- Cirrhosis severity is a critical factor influencing hip fracture surgery outcomes.
- Child-Pugh class C is associated with a substantial increase in in-hospital mortality post-hip fracture surgery.
- Risk-benefit discussions must incorporate cirrhosis severity for optimal patient care decisions.
Background:
Advanced cirrhosis is associated with increased mortality in certain surgeries, but the impact of cirrhosis severity on outcomes in patients with hip fractures remains unclear.
Methods:
In a large nationwide administrative database of hospitalized patients, we compared postoperative outcomes in patients with hip fractures across different Child-Pugh classes of cirrhosis in Japan. Using the Japanese Diagnosis Procedure Combination Database, we identified 833,648 eligible patients diagnosed with hip fractures and underwent surgery between July 2010 and March 2021. Three sets of 1:1 propensity-score matching were performed for four groups: non-cirrhosis cases and Child-Pugh classes A, B, and C. We compared in-hospital mortality, length of stay, hospitalization fees, readmission, and complications in non-cirrhosis cases vs. Child-Pugh class A, Child-Pugh class A vs. B, and Child-Pugh class B vs. C.
Results:
Propensity-score matching created 1065 pairs for non-cirrhosis vs. Child-Pugh class A, 1012 for Child-Pugh class A vs. B, and 489 for Child-Pugh class B vs. C. In-hospital mortality did not differ between non-cirrhosis cases and those with Child-Pugh class A. However, in-hospital mortality was significantly higher in patients with Child-Pugh class B than in those with class A (1.5 % vs. 5.9 %; RD 4.45 %; 95 % CI: 2.79%-6.10 %), and higher in patients with Child-Pugh class C compared with class B (6.3 % vs. 28.4 %; RD 22.09 %; 95 % CI: 17.54%-26.63 %). Patients in more severe Child-Pugh classes had longer hospital stays, higher hospitalization fees, and higher complication rates.
Conclusion:
Patients with hip fractures and cirrhosis who are at high risk of poor postoperative outcomes could be identified. This study highlights the significantly higher in-hospital mortality observed in patients with Child-Pugh class C cirrhosis undergoing hip fracture surgery compared to those with class B. These findings underscore the need for careful risk-benefit discussions, considering the severity of cirrhosis, surgical risks, and care goals for each patient.
More Related Videos
06:17Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
Published on: April 12, 2022
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Related Concept Videos
01:23Cirrhosis I: Introduction
01:24Cirrhosis II: Pathophysiology