August 18, 2015BMC Musculoskeletal DisordersOpen Access

Hemiarthroplasty for displaced femoral neck fracture was associated with a 1.09 times higher hazard for overall death compared to fixation for undisplaced fracture.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Femoral neck fracture (n=27544). Intervention: Hemiarthroplasty for displaced femoral neck fracture vs. Fixation for undisplaced femoral neck fracture. Primary outcome: Overall mortality (10-year) (HR 1.09, 95% CI 1.05-1.12, p=<0.001).

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Why the study?

Does fixation for undisplaced femoral neck fracture compared to hemiarthroplasty for displaced femoral neck fracture affect mortality, medical complications, and reoperation rates in elderly patients?

Population

27,544 inpatients aged 60 years and above from a population database in Taiwan.

Comparison

Fixation surgery for undisplaced femoral neck… vs Hemiarthroplasty surgery for displaced femoral…

Design

Cohort

Follow-up

up to 11 years (from 1998-2007 until end of 2009)

Key result

Hemiarthroplasty for displaced femoral neck fracture was associated with a 1.09 times higher hazard for overall death compared to fixation for undisplaced fracture.

Authors

JLJeff Chien-Fu Lin WLWen-Miin Liang

Discussion

Member takes

Overview

May favor fixation for lower mortality in matched elderly cohorts; leaves open optimal choice pending randomized trials.

Study Design

Type

Cohort (n=27,544)

Structured PICO

Population

27,544 inpatients aged 60 years and older with femoral neck fractures, matched by age, gender, and comorbidities, followed up to 12 years to compare outcomes of fixation versus hemiarthroplasty.

Exposure

Fixation surgery for undisplaced femoral neck fracture

Comparator

Hemiarthroplasty surgery for displaced femoral neck fracture

Outcome

Rates of mortality, medical complication, and reoperationhard clinical

Main Result

Hazard Ratio: 1.09 (95% CI 1.05–1.12)

Absolute Event Rate: 71% vs 67.1%

p-value: p=<0.001

In elderly patients, fixation for undisplaced femoral neck fractures is associated with slightly lower mortality but higher reoperation rates compared to hemiarthroplasty for displaced fractures.

Limitations

The NHRI database does not record all clinical information.
Selection biases may have existed.
Unknown confounding factors might have existed or changed during follow-up.
Many risk factors, such as time to surgery, pre-operative joint function, smoking status, body mass index, and bone mineral density, were not available for adjustment.
Lack of important risk factors in the database requiring further prospective studies

Cite This Study

Lin et al. (2015) conducted a cohort in Femoral neck fracture (n=27,544). Hemiarthroplasty for displaced femoral neck fracture vs. Fixation for undisplaced femoral neck fracture was evaluated on Overall mortality (10-year) (HR 1.09, 95% CI 1.05-1.12, p=<0.001). Hemiarthroplasty for displaced femoral neck fracture was associated with a 1.09 times higher hazard for overall death compared to fixation for undisplaced fracture.

synapsesocial.com/papers/6a62e4653eb69703d1b6db72 https://doi.org/10.1186/s12891-015-0671-6

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August 18, 2015BMC Musculoskeletal DisordersOpen Access

Hemiarthroplasty for displaced femoral neck fracture was associated with a 1.09 times higher hazard for overall death compared to fixation for undisplaced fracture.

View Full Paper

Ask AI

Bookmark

Why the study?

Population

27,544 inpatients aged 60 years and above from a population database in Taiwan.

Comparison

Fixation surgery for undisplaced femoral neck… vs Hemiarthroplasty surgery for displaced femoral…

Design

Cohort

Follow-up

up to 11 years (from 1998-2007 until end of 2009)

Key result

Hemiarthroplasty for displaced femoral neck fracture was associated with a 1.09 times higher hazard for overall death compared to fixation for undisplaced fracture.

Authors

JLJeff Chien-Fu Lin WLWen-Miin Liang

Discussion

Member takes

Overview

May favor fixation for lower mortality in matched elderly cohorts; leaves open optimal choice pending randomized trials.

Study Design

Type

Cohort (n=27,544)

Structured PICO

Population

27,544 inpatients aged 60 years and older with femoral neck fractures, matched by age, gender, and comorbidities, followed up to 12 years to compare outcomes of fixation versus hemiarthroplasty.

Exposure

Fixation surgery for undisplaced femoral neck fracture

Comparator

Hemiarthroplasty surgery for displaced femoral neck fracture

Outcome

Rates of mortality, medical complication, and reoperationhard clinical

Main Result

Hazard Ratio: 1.09 (95% CI 1.05–1.12)

Absolute Event Rate: 71% vs 67.1%

p-value: p=<0.001

In elderly patients, fixation for undisplaced femoral neck fractures is associated with slightly lower mortality but higher reoperation rates compared to hemiarthroplasty for displaced fractures.

Limitations

The NHRI database does not record all clinical information.
Selection biases may have existed.
Unknown confounding factors might have existed or changed during follow-up.
Many risk factors, such as time to surgery, pre-operative joint function, smoking status, body mass index, and bone mineral density, were not available for adjustment.
Lack of important risk factors in the database requiring further prospective studies

Cite This Study

synapsesocial.com/papers/6a62e4653eb69703d1b6db72 https://doi.org/10.1186/s12891-015-0671-6

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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