Risk factors for the second contralateral hip fracture in elderly patients: a systematic review and meta-analysis.

Abstract

Objectives: To achieve a quantitative and comprehensive conclusion concerning the risk factors for the second contralateral hip fracture in elderly patients with initial hip fractures.

Data sources: This search was applied to Medline, Embase, Cochrane central database (all up to April 2014).

Methods: All the studies on bilateral hip fractures in elderly patients published in English were reviewed and qualities of included studies were assessed using the Newcastle-Ottawa Scale. All the data were carefully and independently abstracted by two reviewers, any disagreement was settled by discussion. Data was pooled and a meta-analysis completed.

Results: A total of 13 case-control studies were identified for the meta-analysis. The significant risk factors were female (odds ratio (OR), 1.30; 95% confidence interval (CI), 1.02-1.64), living in institutions (OR, 2.53; 95% CI, 1.33-4.85), osteoporosis (OR, 10.02; 95% CI, 5.41-18.57), low vision (OR, 2.09; 95% CI, 1.06-4.12), dementia (OR, 2.02; 95% CI, 1.54-2.65), dizziness (OR, 2.87; 95% CI, 1.42-5.87) cardiac diseases (OR, 1.33; 95% CI, 1.00-1.78) and respiration diseases (OR, 2.58; 95% CI, 1.22-5.47). No significant difference was found in admission age between patients with the unilateral hip fracture and the first hip fracture of bilateral hip groups (standardized mean difference, 0.02, 95% CI, -0.30 to 0.35].

Conclusions: Patients involved with female, living in institutions, osteoporosis, low vision, dizziness, dementia, respiration diseases and cardiac diseases were at risk for a second contralateral hip fracture after the initial hip fracture.