Mortality Risk Up for Hip Surgery After Fracture Vs Elective THR
(HealthDay News) — Patients undergoing surgery for hip fracture have a higher risk of mortality and major complications than those receiving an elective total hip replacement, according to research published online Sept. 15 in JAMA.
Yannick Le Manach, M.D., Ph.D., of McMaster University in Canada, and colleagues examined the differences in outcomes for a cohort of patients undergoing hip fracture surgery (319,804 patients) versus a cohort undergoing elective total hip replacement (THR) surgery (371,191 patients). Multivariable analysis was performed using a population matched for age, sex, and preoperative comorbidities of patients undergoing hip fracture surgery or elective THR.
The researchers found a higher rate of in-hospital mortality for hip fracture surgery versus elective THR (3.42 versus 0.18 percent). Multivariable analysis of the matched populations (n=234,314) showed a higher risk of mortality (1.82 vs 0.31 percent, respectively; absolute risk increase, 1.51 percent; relative risk [RR], 5.88) and of major postoperative complications (5.88 vs 2.34 percent, respectively; absolute risk increase, 3.54 percent; RR, 2.5) for hip fracture surgery versus elective THR.
"In a large cohort of French patients, hip fracture surgery compared with elective THR was associated with a higher risk of in-hospital mortality after adjustment for age, sex, and measured comorbidities," the authors write. "Further studies are needed to define the causes for these differences."
Several authors report financial ties to pharmaceutical, medical device, and biomedical companies.