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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Research

Primary hemiarthroplasty after unstable trochanteric fracture in elderly patients: mortality, readmission and reoperation

Authors: Tzu-Chieh Lin, Pin-Wen Wang, Chun-Teng Lin, Yu-Jun Chang, Ying-Ju Lin, Wen-Miin Liang, Jeff Chien-Fu Lin

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Most unstable trochanteric fractures are treated with internal fixation and often with high complication rates. Hemiarthroplasty might be an alternative method in difficult condition, especially in unstable comminuted fracture in fragile bone. However, few have investigated the long-term outcomes after hemiarthroplasty for unstable trochanteric fracture. We conducted a population-based retrospective cohort study of trochanteric fracture after primary hemiarthroplasty using competing risk analysis on their long-term outcomes, including mortality, readmission and reoperation.

Methods

We studied a total of 2798 patients over 60 years old, with a mean age of 79 years, of which 68% are females and 67.23% have at least one comorbidity. They underwent a hemiarthroplasty for unstable trochanteric fracture during the period between January 1, 2000 and December 31, 2010 and were follow-up until the end of 2012, or death. Survival analysis and Cox model were used to characterize mortality. Competing risk analysis and Fine and Gray model were used to estimate the cumulative incidences of the first readmission and the first reoperation.

Results

The follow-up mortality rate for 1-year was 17.94%; 2-year, 29.76%; 5-year, 56.8%; and 10-year, 83.38%. The cumulative incidence of the first readmission was 16.4% for 1-year and 22.44% for 3-year. The cumulative incidence of the first reoperation was 13.87% for 1-year, 18.11% for 2-year, 25.79% for 5-year, and 38.24% for 10-year. Male gender, older age, higher Charlson Comorbidity Index (CCI) and lower insured amount were all risk factors for the overall mortality. Older age and higher CCI were risk factors for the first readmission. Older age was a protective factor for reoperation, which is likely due to the competing death.

Conclusions

The mortality and revision rates after hemiarthroplasty for unstable trochanteric fracture are acceptable as a salvage procedure for this fragile sub-population.

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Title: Primary hemiarthroplasty after unstable trochanteric fracture in elderly patients: mortality, readmission and reoperation
Authors: Tzu-Chieh Lin
Pin-Wen Wang
Chun-Teng Lin
Yu-Jun Chang
Ying-Ju Lin
Wen-Miin Liang
Jeff Chien-Fu Lin
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04277-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Primary hemiarthroplasty after unstable trochanteric fracture in elderly patients: mortality, readmission and reoperation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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