Fractura bilateral de cadera no simultánea. Estudio de cohorte retrospectiva

Abstract

Background and aimAfter a first hip fracture, the contralateral hip can also get fractured. The characteristics of this second hip fracture are determined and its differences with the first one are evaluated. Materials and methodsRetrospective cohort study was conducted that included patients older than 50 years old with a hip fracture. Patients were excluded if they had pathological fractures, high-energy fractures, peri-prosthetic fractures, bilateral simultaneous fracture, a history of ipsilateral hip fracture, and ipsilateral simultaneous femur fracture. A total of 610 patients with a fracture over a 10-year period (2005-2014) were eligible at the institution. They were divided in two groups: first and second hip fracture. The incidence of non-simultaneous bilateral hip fracture was calculated and for each group, the demographic variables, complications, comorbidities, and mortality were recorded. ResultsThe incidence of non-simultaneous bilateral hip fracture was 8.0% (n=49). The mean time between the first and second fracture was 2.3 years. Patients were, on average, 85 years-old when they fractured the second time, and 6 years older than for the first fracture. Of the 49 patients included, 77.6% were women (n=38), with a ratio of 3.5 to 1 in relation to men. There were more medical complications for the second fracture, as well as a higher prevalence of dementia and diabetes. The 3 months mortality rate was higher for the second fracture: 10.2% vs 6.9%, with a RR=1.46 (95% CI: 0.6-3.6) (p=.39). DiscussionThe second fracture occurs several years after the first one, is more frequent in women, and could be associated with more complications and higher mortality. Level of evidenceII.