Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients

JAAOS Global Research & Reviews · 5 authors, 1 centre

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TL;DR

This retrospective cohort study of 104,311 geriatric patients found that the 10-year incidence of a second hip fracture on the opposite side was 12.9%, with the majority occurring within the first two years. Female sex, low body mass index, and treatment with percutaneous pinning for the initial fracture were identified as independent risk factors.

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This study analyzed a national administrative dataset to identify 104,311 geriatric patients with an initial hip fracture and followed them for 10 years. Multivariate logistic regression on the 2-year subset identified female sex, body mass index less than 20, and percutaneous pinning surgery for initial fixation as independent predictors of contralateral fracture. The study's large, national cohort strengthens its statistical power, but limitations include reliance on administrative data accuracy and potential attrition bias due to patient mortality over the long follow-up period.

STUDY TYPE

cohort

SPECIALTY

geriatrics

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ORIGINAL PAPER

PMC10332831

Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients

JAAOS Global Research & Reviews

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ABSTRACT

Background: Geriatric hip fractures are common and associated with high morbidity and mortality. This study aimed to evaluate the incidence, timing, and risk factors of contralateral hip fracture after initial hip fracture. Methods: Initial hip fractures in patients older than 65 years were abstracted from the national, administrative M91Ortho PearlDiver data set. Incidence and timing of contralateral hip fractures in the following 10 years were identified. Kaplan-Meier survival analysis until contralateral hip fracture was conducted. To account for patient mortality over the later years, 2-year univariate and multivariate analyses were used to determine factors predictive of contralateral hip fracture. Results: Of the initial 104,311 hip fractures identified, contralateral hip fracture in the 10 years that followed was identified for 7,186 (6.9%), of which 68.4% occurred in the first 2 years. Kaplan-Meier survival analysis until contralateral fracture revealed the 10-year incidence to be 12.9% when controlling for those lost from the data set during the study period. Multivariate logistic regression revealed independent predictors of contralateral hip fracture in the 2 years after index hip fracture, when the incidence was greatest, to be female sex (odds ratio [OR] 1.15), body mass index < 20 (OR 1.30), and percutaneous pinning surgery for initial hip fracture fixation (OR 1.58) ( P < 0.0001 for each). Conclusions: In a national cohort of 104,311 geriatric hip fractures, Kaplan-Meier analysis for contralateral hip fracture found the 10-year incidence to be 12.9%, of which nearly 70% were in the first 2 years, and predisposing factors were defined. As such, future research should aim to identify the cause and mitigate the risk of secondary contralateral hip fractures in geriatric patients.

CITATION EXPORT

Philip P. Ratnasamy, Katelyn E. Rudisill, Oghenewoma P. Oghenesume et al.. Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients. JAAOS Global Research & Reviews. (2023). https://doi.org/10.5435/JAAOSGlobal-D-23-00001

AUTHORS

5 · 1 CENTRES

Philip P. Ratnasamy, Katelyn E. Rudisill, Oghenewoma P. Oghenesume, Matthew D. Riedel, Jonathan N. Grauer

From the Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT.