Short-term risk factors for second hip fracture

  • Sheikh HQ & al.
  • Eur J Orthop Surg Traumatol
  • 12 Mar 2019

  • curated by Pavankumar Kamat
  • UK Clinical Digest
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Takeaway

  • A study has identified discrete risk factors associated with a short- to medium-term risk for a second hip fracture that include dementia, chest and/or urinary infections and increasing comorbidity.

Why this matters

  • Evidence suggests that patients who sustain a first hip fracture have an 11-15% higher risk for second hip fracture within 10 years.

Study design

  • Retrospective analysis of 1242 patients with hip fractures admitted to a large hospital in the UK.
  • Patients with a subsequent contralateral hip fracture in the following 2 years and risk factors associated with the same were identified.
  • Funding: None disclosed.

Key results

  • 5.3% of patients sustained a contralateral hip fracture within 2 years following initial hip fracture.
  • On univariate analysis, patients sustaining a contralateral hip fracture had a greater likelihood of being female, having a higher platelet count at admission and lower serum sodium and creatinine levels.
  • On multivariate analysis, risk factors significantly associated with a higher risk for second fracture included chest infection during the index admission (HR, 1.907; 95% CI, 1.038-3.503; P=.037), urinary tract infections (HR, 1.858; 95% CI, 1.065-3.242; P=.029), dementia (HR, 2.163; 95% CI, 1.087-4.304; P=.028), and increasing comorbidities as per Charlson score (HR, 1.229; 95% CI, 1.001-1.510; P=.049).

Limitations

  • Single-centre study and short follow-up duration.

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