A register-based analysis: the impact of contralateral hip fractures in the past six months on geriatric hip fracture patients.

Abstract

Subsequent contralateral hip fractures pose a significant challenge in the management of geriatric patients. This study aimed to evaluate the impact of contralateral hip fractures within the past six months in patients with hip fractures. A registry-based cohort study with prospective follow-up was conducted using data from hip fracture patients (femoral neck and pertrochanteric fractures) in Germany, Switzerland, and Austria. Patients with a contralateral hip fracture in the past six months (risk group) were compared to those without (control group). Matching analysis was performed to adjust for confounding factors, including age, sex, American Society of Anesthesiologists (ASA) grade, pre-fracture mobility, and fracture type. The primary outcome was mobility seven days postoperatively, while secondary outcomes included the EQ-5D-5 L index, length of hospital stay, necessity for intensive care unit, reoperation rate, discharge destination, mortality, and complications. Before matching, patients in the risk group exhibited significantly worse mobility and functional outcomes than those in the control group. However, after adjusting for confounders, no significant differences in mobility or the EQ-5D-5 L index remained. No significant difference was found in the in-house and mid-term mortality rate. The risk group was prone to having a higher risk of delirium and decubitus ulcers without statistical significance. In contrast, the risk of renal failure was significantly lower. Contralateral hip fractures in the past six months are associated with inferior early mobility and functional outcomes in general. However, this association was not independent.