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Increased postoperative complication risk in elderly hip fracture patients with cerebrovascular disorders: A

Yu Mori1, Kunio Tarasawa2, Hidetatsu Tanaka1

  • 1Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-Ku, Sendai, Miyagi 980-8574, Japan.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
|November 13, 2025
PubMed

Insights

Elderly patients with cerebrovascular disorders face higher risks of postoperative pneumonia, urinary tract infections, and cognitive dysfunction after hip fracture surgery. This highlights the need for integrated care strategies.

Area of Science:

  • Geriatric Medicine
  • Neurology
  • Orthopedic Surgery

Background:

  • Cerebrovascular disorders are recognized risk factors for hip fractures in older adults.
  • The impact of cerebrovascular disorders on postoperative complications after hip fracture surgery is not well-understood.

Purpose of the Study:

  • To investigate the association between cerebrovascular disorders and postoperative complications in elderly patients undergoing hip fracture surgery.
  • To identify specific complications linked to cerebrovascular disorders in this patient population.

Main Methods:

  • Retrospective cohort study using the Japanese Diagnosis Procedure Combination (DPC) database (April 2016-March 2022).
  • Included patients aged ≥65 years who had hip fracture surgery; cerebrovascular disorders identified by ICD-10 codes (I60-I64).
  • Propensity score matching (1:1) was employed to control for confounding factors.

Main Results:

  • Analysis of 46,158 matched pairs revealed cerebrovascular disorders independently increased risks of pneumonia (aOR 1.515), urinary tract infection (aOR 1.336), and cognitive dysfunction (aOR 1.237).
  • No significant difference in in-hospital mortality was found between groups.
  • Patients with cerebrovascular disorders experienced longer hospital stays (38.2 vs. 35.6 days).

Conclusions:

  • Cerebrovascular disorders are linked to increased postoperative infectious and cognitive complications in elderly hip fracture patients.
  • Findings emphasize the importance of considering cerebrovascular history in perioperative risk assessment.
  • Optimizing multidisciplinary care strategies is crucial for managing these patients.
Abstract

Keywords:
Cerebrovascular disorderHip fractureNationwide databaseOsteoporosisPerioperative complication

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