M R Whitehouse1, J R Berstock1, M B Kelly2, C L Gregson1, A Judge1, A Sayers1, T J Chesser2. 1. Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK; Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK; National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, UK. 2. Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.
Abstract
AIMS: The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality. PATIENTS AND METHODS: Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors. RESULTS: The use of short and long intramedullary nails was associated with an increase in 30-day mortality (adjusted odds ratio (OR) 1.125, 95% confidence interval (CI) 1.040 to 1.218; p = 0.004) compared with the use of sliding hip screws (12.5% increase). If this were causative, it would represent 98 excess deaths over the four-year period of the study and one excess death would be caused by treating 112 patients with an intramedullary nail rather than a sliding hip screw. CONCLUSION: There is a 12.5% increase in the risk of 30-day mortality associated with the use of an intramedullary nail compared with a sliding hip screw in the treatment of a trochanteric fractures of the hip.
AIMS: The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality. PATIENTS AND METHODS: Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors. RESULTS: The use of short and long intramedullary nails was associated with an increase in 30-day mortality (adjusted odds ratio (OR) 1.125, 95% confidence interval (CI) 1.040 to 1.218; p = 0.004) compared with the use of sliding hip screws (12.5% increase). If this were causative, it would represent 98 excess deaths over the four-year period of the study and one excess death would be caused by treating 112 patients with an intramedullary nail rather than a sliding hip screw. CONCLUSION: There is a 12.5% increase in the risk of 30-day mortality associated with the use of an intramedullary nail compared with a sliding hip screw in the treatment of a trochanteric fractures of the hip.
Entities:
Keywords:
Intramedullary nail; Mortality; National Hip Fracture Database; Neck of femur fracture; Sliding hip screw; Trochanteric hip fracture
Authors: Gulraj S Matharu; Anjali Shah; Samuel Hawley; Antony Johansen; Dominic Inman; Iain Moppett; Michael R Whitehouse; Andrew Judge Journal: BMC Med Date: 2022-09-26 Impact factor: 11.150
Authors: Olof Wolf; Sebastian Mukka; Jan Ekelund; Cecilia Rogmark; Michael Möller; Nils P Hailer Journal: Acta Orthop Date: 2022-01-03 Impact factor: 3.717
Authors: E A Murphy; B Ehrhardt; C L Gregson; O A von Arx; A Hartley; M R Whitehouse; M S Thomas; G Stenhouse; T J S Chesser; C J Budd; H S Gill Journal: Sci Rep Date: 2022-02-08 Impact factor: 4.379