Hip fracture patients have worse outcomes in comparison with hip replacement surgery patients, and this finding is not entirely explained by age or medical condition, according to a study published September 15 in JAMA.
Researchers studied nearly 700,000 hip surgery patients older than 45 in France between 2010 and 2013 and found that the total hip replacement patients were younger, more commonly men, and had fewer comorbidities than hip fracture patients.
Yannick Le Manach, MD, PhD
Investigators also found there were more deaths among the hip fracture patients, with 3.4% dying before hospital discharge compared with 0.18% of total hip replacement surgery patients.
Even when the demographics of the patients were matched by gender, age, and medical conditions, study authors found hip fracture patients had a 1.8% chance of dying compared with 0.3% of elective hip replacement patients. People with a hip fracture had a 5.9% chance of major postoperative complications, compared with 2.3% of those patients who underwent an elective hip replacement.
The research team was led by Yannick Le Manach, MD, PhD, an Assistant Professor of Anesthesia for the Michael G. DeGroote School of Medicine of McMaster University and a member of the Population Health Research Institute of McMaster and Hamilton Health Sciences in Hamilton, Ontario.
“The fact that the hip fracture patients were older and had more health problems does account for some of the difference in outcomes,” Dr. Le Manach said. “But it may be that hip fracture is tied to other physiologic processes that are not present in the circumstances of people going for an elective hip replacement. More research is needed.”
Senior author P.J. Devereaux, MD, PhD, Professor of Medicine and Director of Cardiology for the Michael G DeGroote School of Medicine stated, “These results are encouraging that there are likely risk factors specific to a hip fracture that are potentially modifiable.”