926 Long-Term Outcomes of Internal Fixation vs Hemiarthroplasty for Femoral Neck Fractures: A Quantitative Analysis of the Correlation Between Harris Hip Score and Mortality in Elderly Patients

Aim Trials that assess differences over time in HHS (Harris Hip Score), for both hemiarthroplasty and internal fixation post NOF (neck of femur) fractures, are limited. NOF fractures are more common in elderly patients and have high associated risks of mortality. Mortality rates after hemiarthroplasty or internal fixation vary in the literature. A quantitative relationship between HHS and mortality after these surgical interventions between 12 and 24 months is not known. This study aims to calculate this relationship. Method PubMed and Cochrane were searched for randomised controlled trials up to 7.11.23, reporting HHS over 12, and 24 months. Data was extracted by 4 researchers. The differences in HHS over time post hemiarthroplasty and fixation was assessed using unpaired T testing. 905 records were screened. 3 studies enrolling 544 participants met the eligibility criteria and were analysed. Results Our analysis showed an insignificant correlation between weighted HHS and mortality in fixation procedure outcomes (r=0.28, r^2= 0.08), However, revealed a relatively strong negative correlation in hemiarthroplasty procedure outcomes (r=-0.67, r^2=0.44). No significant relationships could be determined (p>0.05). Conclusions Known changes to the relationship between HHS and mortality over time could affect the choice of surgical intervention for a NOF fracture for patients with greater comorbidities and surgical risk. This could inform future clinical trial design and surgical decision-making. Further studies are required to formally assess a correlation between HHS and mortality over time - specifically between 12 and 24 months.