Abstract
IntroductionA hip fracture carries significant morbidity and mortality—a second fracture of the contralateral hip carries even higher complications. Most second hip fractures occur within 48 months of the first. The aim of this study was to comprehensively analyse all identifiable variables that may increase the risk of a contralateral hip fracture within this time period.MethodsWe retrospectively analysed 1242 consecutive patients with hip fractures presenting to our institution. All patient-related, surgery-related and inpatient variables were collected from the index admission. We then identified patients with a subsequent contralateral hip fracture in the following 2 years. Univariate and multivariate analyses were performed to identify risk factors associated with a second fracture.ResultsA total of 66 patients (5.3%) had a contralateral hip fracture in the 2 years following initial hip fracture. Mean age at first presentation was 81 years, and mean time to second fracture was 305 days. Following multivariate analysis, the patients at highest risk of a second fracture were those with dementia, acute inpatient chest infection, urinary tract infection and multiple comorbidities as measured by the Charlson score. Discharge destination after initial fracture was not associated with the risk of a second fracture.ConclusionsWe have identified a number of discrete risk factors that are associated with a short- to medium-term risk of contralateral hip fracture that may be useful in screening for patients at risk and provide them with focused medical rehabilitation.
Highlights
A hip fracture carries significant morbidity and mortality—a second fracture of the contralateral hip carries even higher complications
We have identified a number of discrete risk factors that are associated with a short- to medium-term risk of contralateral hip fracture that may be useful in screening for patients at risk and provide them with focused medical rehabilitation
Patients at significantly increased risk of a second hip fracture within 48 months were likely to have suffered from a chest infection, urine infections, have dementia and increasing comorbidities compared to patients that did not
Summary
A hip fracture carries significant morbidity and mortality—a second fracture of the contralateral hip carries even higher complications. Barnsley Hospital Trust, Gawber Rd, Barnsley S75 2EP, UK 3 Bradford Teaching Hospitals, Duckworth Ln, Bradford BD9 6RJ, UK second hip fracture [4] They have 2.5 times increased risk of other types of fracture [5]. Following a second hip fracture, patients are less likely to maintain their walking ability and social independence Their mortality is significantly higher, and they are likely to be older, in full-time care and suffer from dementia [6, 7]. It would be prudent, to identify and target modifiable risk factors that may increase the risk of a second hip fracture to reduce its incidence
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