An analysis of cost and complications for patients sustaining a second, contralateral hip fracture within 1 year

• Published in: Injury 2023-06, Vol.54 (6), p.1748-1751
• Main Authors: Makar, Gabriel S., Rocha, Daniella Barreto, Nester, Jordan, Torino, Daniel, Udoeyo, Idorenyin F., Maniar, Hemil Hasmukh, Horwitz, Daniel Scott
• Format: Article
• Language: English
• Subjects: Contralateral hip fracture; Hip fracture complications; Hip fracture cost; Second hip fracture
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2023.04.013

•There was no statistically significant difference in complications associated between patients first and contralateral second hip fracture.•Patients with a second hip fracture had higher rates of cognitive impairment.•Surgical costs and operative times were not significantly different between patients first and contralateral second hip fracture. Hip fractures are an increasingly common occurrence among the aging population. With increased life expectancy and advancements in medicine, patients sustaining a hip fracture are at an increasing risk of sustaining a contralateral hip fracture. Efforts are being made to better understand the environment of these hip fractures so that secondary prevention clinics and guidelines can be made to help prevent recurrent osteoporotic hip fractures. The estimated incidence of a contralateral hip fracture varies from 2 to 10% and is reportedly associated with a higher incidence of complications. Previous studies evaluating contralateral hip fractures compared a single cohort of patients sustaining a second hip fracture with patients who sustained only one hip fracture. We aimed to investigate the overall complications and associated costs as it relates to a patients first hip fracture and contrast this to the same patient's contralateral, second hip fractures. We performed a retrospective review of all patients in our health systems electronic database who were found to have surgically treated hip fractures between January 2004 and July 2019. Patients with surgically treated hip fractures (CPT Codes: 27235, 27236, 27245, 27244), who sustained a second contralateral hip fracture were included. Medical complications within 30 days of either procedure (such as pneumonia, UTI, altered mental status and others), length of stay, orthopedic complications (such as wound complications, infection, hardware failure, nonunion), type of implants, costs, comorbidities, and ASA Class as well as Mortality were reviewed. A total of 4,870 hip fractures were identified during the study period where 137 (2.8%) patients sustained a second hip fracture, and 47 (0.9%) of which were sustained within the first year after their index hip fracture. There was no statistical difference in length of stay (p = 0.68), medical (p>0.99) or orthopedic complications (p>0.99) between patients first and second hip fractures. There was an increased incidence of cognitive impairment with the second hip fracture (P = 0.0002). For patients that underwent operativ