Complication overview following hip fracture surgery: insights from a prospective multicenter cohort study

The primary aim of this study was to present an up-to-date overview of postoperative complications during hospitalization of patients undergoing hip fracture surgery in a Western European country. The secondary aim of this study was to evaluate clinical outcomes (length of hospital stay and mortality) in relation to postoperative complications.

A prospective proximal femoral fracture database was used to obtain data. In total, 2603 patients older than 18 years undergoing hip fracture surgery between January 2018 and January 2021 were included. Baseline characteristics, clinical outcomes and postoperative complications were retrospectively analyzed. Complications were categorized as minor or major (requiring medical intervention and prolonged hospital stay).

Of 2603 patients, 51% experienced at least one complication. Major complications occurred in 30% of all cases. The most frequent major complications were delirium (16%), pneumonia (9%), and urinary tract infections (UTI) (8%). Minor complications occurred in 19% of all cases. The most frequent minor complication was anemia requiring transfusion (19%). Of all major complications delirium, pneumonia, and acute kidney injury (AKI) were significantly associated with increased 30-day and 1-year mortality (p < 0.001).

Proximal femoral fractures are associated with a high overall incidence of complications. Most complications are associated with either a significantly longer hospitalization or higher 30-day and 1-year mortality rates.

Level II prospective multicenter cohort study.