Predictors of mortality in periprosthetic fractures of the hip : results from the national PPF study
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Nasser, Ahmed Abdul Hadi HarbPrakash, Rohan
Handford, Charles
Osman, Khabab
Chauhan, Govind Singh
Nandra, Rajpal
Mahmood, Ansar
Dewan, Varun
Davidson, Jerome
Al-Azzawi, Mohammed
Smith, Christian
Gawad, Mothana
Palaiologos, Ioannis
Cuthbert, Rory
Wignadasan, Warran
Banks, Daniel
Archer, James
Odeh, Abdulrahman
Moores, Thomas
Tahir, Muaaz
Brooks, Margaret
Biring, Gurdeep
Jordan, Stevan
Elahi, Zain
Shaath, Mohammed
Veettil, Manoj
De, Chiranjit
Handford, Charles
Bansal, Mohit
Bawa, Akshdeep
Mattar, Ahmed
Tandra, Varun
Daadipour, Audrina
Taha, Ahmed
Gangoo, Shafat
Srinivasan, Sriram
Tarisai, Mandishona
Budair, Basil
Subbaraman, Krishna
Khan, Farrukh
Gomindes, Austin
Samuel, Arjun
Kang, Niel
Kapur, Karan
Mainwaring, Elizabeth
Bridgwater, Hannah
Lo, Andre
Ahmed, Usman
Khaleeq, Tahir
El-Bakoury, Ahmed
Rashed, Ramy
Hosny, Hazem
Yarlagadda, Rathan
Keenan, Jonathan
Hamed, Ahmed
Riemer, Bryan
Qureshi, Arham
Gupta, Vatsal
Waites, Matthew
Bleibleh, Sabri
Westacott, David
Phillips, Jonathan
East, Jamie
Huntley, Daniel
Masud, Saqib
Mirza, Yusuf
Mishra, Sandeep
Dunlop, David
Khalefa, Mohamed
Balasubramanian, Balakumar
Thibbaiah, Mahesh
Payton, Olivia
Berstock, James
Deano, Krisna
Sarraf, Khaled
Logishetty, Kartik
Lee, George
Subbiah-Ponniah, Hariharan
Shah, Nirav
Venkatesan, Aakaash
Cheseldene-Culley, James
Ayathamattam, Joseph
Tross, Samantha
Randhawa, Sukhwinder
Mohammed, Faisal
Ali, Ramla
Bird, Jonathan
Khan, Kursheed
Akhtar, Muhammad Adeel
Brunt, Andrew
Roupakiotis, Panagiotis
Subramanian, Padmanabhan
Bua, Nelson
Hakimi, Mounir
Bitar, Samer
Najjar, Majed Al
Radhakrishnan, Ajay
Gamble, Charlie
James, Andrew
Gilmore, Catherine
Dawson, Dan
Sofat, Rajesh
Antar, Mohamed
Raghu, Aashish
Heaton, Sam
Tawfeek, Waleed
Charles, Christerlyn
Burnand, Henry
Duffy, Sean
Taylor, Luke
Magill, Laura
Perry, Rita
Pettitt, Michala
Okoth, Kelvin
Pinkney, Thomas
Affiliation
The Royal Orthopaedic Hospital; The Birmingham Orthopaedic Network; Birmingham Queen Elizabeth Hospital; St Thomas Hospital; The Whittington Hospital; New Cross Hospital; Walsall Healthcare NHS Trust; Stoke Mandeville Hospital; Sandwell General Hospital; Princess Royal University Hospital; James Paget Hospital; Addenbrooke's Hospital; Princess Royal Hospital; Derriford Hospital; University Hospital Coventry & Warwickshire; Russell's Hall Hospital; Royal Devon and Exeter Hospital; Morriston Hospital; Royal United Hospital; St Mary's Hospital; Worthing Hospital; Ealing Hospital; University Hospital Lewisham; Victoria Hospital; Barnet General Hospital; Salford Royal Hospital; Ulster Hospital; Lister Hospital; Yeovil District Hospital; Bristol Royal Infirmary; University of BirminghamPublication date
2023-12-01Subject
Orthopaedics
Metadata
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Introduction: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip. Methods: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period. Univariate and multivariable logistic regression analyses were performed to study the independent correlation between patient, fracture, and treatment factors on mortality. Results: A total of 1,109 patients were included. The in-hospital mortality rate was 5.3%. Multivariable analyses suggested that age, male sex, abbreviated mental test score (AMTS), pneumonia, renal failure, history of peripheral vascular disease (PVD) and deep surgical site infection were each independently associated with mortality. Each yearly increase in age independently correlates with a 7% increase in mortality (OR 1.07, p=0.019). The odds of mortality was 2.99 times higher for patients diagnosed with pneumonia during their hospital stay [OR 2.99 (95% CI 1.07-8.37) p=0.037], and 7.25 times higher for patients that developed renal failure during their stay [OR 7.25 (95% CI 1.85-28.47) p=0.005]. Patients with history of PVD have a six-fold greater mortality risk (OR 6.06, p=0.003). Mode of treatment was not a significant predictor of mortality. Conclusion: The in-hospital mortality rate of PPFs around the hip exceeds 5%. The fracture subtype and mode of management are not independent predictors of mortality, while patient factors such as age, AMTS, history of PVD, pneumonia, and renal failure can independently predict mortality. Peri-operative optimisation of modifiable risk factors such as lung and kidney function in patients with PPFs around the hip during their hospital stay is of utmost importance.Citation
Nasser AAHH, Prakash R, Handford C, Osman K, Chauhan GS, Nandra R, Mahmood A, Dewan V, Davidson J, Al-Azzawi M, Smith C, Gawad M, Palaiologos I, Cuthbert R, Wignadasan W, Banks D, Archer J, Odeh A, Moores T, Tahir M, Brooks M, Biring G, Jordan S, Elahi Z, Shaath M, Veettil M, De C, Handford C, Bansal M, Bawa A, Mattar A, Tandra V, Daadipour A, Taha A, Gangoo S, Srinivasan S, Tarisai M, Budair B, Subbaraman K, Khan F, Gomindes A, Samuel A, Kang N, Kapur K, Mainwaring E, Bridgwater H, Lo A, Ahmed U, Khaleeq T, El-Bakoury A, Rashed R, Hosny H, Yarlagadda R, Keenan J, Hamed A, Riemer B, Qureshi A, Gupta V, Waites M, Bleibleh S, Westacott D, Phillips J, East J, Huntley D, Masud S, Mirza Y, Mishra S, Dunlop D, Khalefa M, Balasubramanian B, Thibbaiah M, Payton O, Berstock J, Deano K, Sarraf K, Logishetty K, Lee G, Subbiah-Ponniah H, Shah N, Venkatesan A, Cheseldene-Culley J, Ayathamattam J, Tross S, Randhawa S, Mohammed F, Ali R, Bird J, Khan K, Akhtar MA, Brunt A, Roupakiotis P, Subramanian P, Bua N, Hakimi M, Bitar S, Najjar MA, Radhakrishnan A, Gamble C, James A, Gilmore C, Dawson D, Sofat R, Antar M, Raghu A, Heaton S, Tawfeek W, Charles C, Burnand H, Duffy S, Taylor L, Magill L, Perry R, Pettitt M, Okoth K, Pinkney T. Predictors of mortality in periprosthetic fractures of the hip: Results from the national PPF study. Injury. 2023 Dec;54(12):111152Type
ArticlePMID
37939635Journal
InjuryPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.injury.2023.111152
Scopus Count
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