Unplanned emergency department visits within 90 days of hip hemiarthroplasty for osteoporotic femoral neck fractures: Reasons, risks, and mortalities

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Osteoporosis and Sarcopenia Pub Date : 2024-06-01 DOI:10.1016/j.afos.2024.05.005
Yang-Yi Wang , Yi-Chuan Chou , Yuan-Hsin Tsai , Chih-Wei Chang , Yi-Chen Chen , Ta-Wei Tai
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Abstract

Objectives

Bipolar hemiarthroplasty is commonly performed to treat displaced femoral neck fractures in osteoporotic patients. This study aimed to assess the occurrence and outcomes of unplanned return visits to the emergency department (ED) within 90 days following bipolar hemiarthroplasty for displaced femoral neck fractures.

Methods

The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients’ electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed.

Results

Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient's returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P < 0.001) and a greater overall mortality rate (26.2% vs 10.5%, P < 0.001).

Conclusions

This study highlights the importance of identifying risk factors for unplanned ED visits after bipolar hemiarthroplasty, which may contribute to a better prognosis. Consideration should be given to the use of cemented implants for hemiarthroplasty, as uncemented implants are associated with a greater risk of periprosthetic fractures.

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髋关节半关节置换术治疗骨质疏松性股骨颈骨折 90 天内的计划外急诊就诊:原因、风险和死亡率
目的双极半关节置换术通常用于治疗骨质疏松患者的股骨颈移位性骨折。本研究旨在评估双极半关节置换术治疗股骨颈移位性骨折后 90 天内急诊科(ED)意外复诊的发生率和结果。研究人员收集了患者的电子病历数据,包括人口统计学信息、合并症和手术细节。结果术后90天内,19.9%的患者返回急诊室。20.2%的患者返回急诊室的原因与手术有关。年龄较大、夏尔森综合症指数得分较高、慢性肾病和癌症病史被认为是非计划性急诊就诊的重要风险因素。植入非骨水泥假体的患者因假体周围骨折返回急诊室的风险明显高于植入骨水泥假体的患者(P = 0.04)。90天内重返急诊室的患者1年死亡率(15.2% vs 3.1%,P < 0.001)和总死亡率(26.2% vs 10.5%,P < 0.001)几乎高出5倍。应考虑在半关节成形术中使用骨水泥植入物,因为非骨水泥植入物与更高的假体周围骨折风险相关。
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来源期刊
Osteoporosis and Sarcopenia
Osteoporosis and Sarcopenia Orthopedics, Sports Medicine and Rehabilitation, Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Geriatrics and Gerontology
自引率
5.00%
发文量
23
审稿时长
66 days
期刊最新文献
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