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February 4, 2025International OrthopaedicsOpen Access

Comparison of Hemiarthroplasty, total hip arthroplasty, and internal fixation for hip fractures in patients over eighty years of age: factors affecting mortality: a nationwide cohort study of fifty three thousand, four hundred and ninety five patients from Türkiye

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Why the study?

Hip fractures are a common cause of mortality in elderly patients, prompting this study to determine predictive factors affecting mortality in patients over 80 undergoing surgical treatment.

Does the type of surgery (hemiarthroplasty, internal fixation vs total hip arthroplasty) affect one-year mortality in patients over 80 years of age with hip fractures?

Population

53,495 patients over 80 years old who underwent surgery for proximal femoral fractures

Comparison

Hemiarthroplasty vs internal fixation vs total hip arthroplasty

Design

Nationwide cohort study

Authors

KUKadir UzelWollongong HospitalMBMurat BirinciÜmraniye Eğitim ve Araştırma HastanesiÖHÖmer Serdar HakyemezState Hospital

Discussion

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Member takes

Overview

May aid risk stratification after hip fracture surgery in patients >80; leaves open whether modifying predictors improves survival.

Structured PICO

Does the type of surgery (hemiarthroplasty, internal fixation vs total hip arthroplasty) affect one-year mortality in patients over 80 years of age with hip fractures?

P
Population
53,495 patients aged ≥80 years who underwent surgery (internal fixation, hemiarthroplasty, or total hip arthroplasty) for proximal femoral fractures (femoral neck or intertrochanteric) from 2016 to 2022 in Türkiye. Mean age 86, 67% female.
I
Intervention
Hemiarthroplasty (HA) or Internal Fixation (IF)
C
Comparator
Total Hip Arthroplasty (THA)
O
Outcome
One-year mortalityhard clinical

Limitations

  • Information bias due to retrospective national database design
  • Influence of unmeasured confounding variables and selection bias
  • Lack of laboratory values or physiological variables (e.g., anticoagulant use)
  • Misclassification and missing data due to reliance on ICD-10 codes
  • No clear indication for treatment choice and lack of stratification by surgeon volume/experience

Cite This Study

Uzel et al. (2025) studied this question.

synapsesocial.com/papers/6a6f92fe22b3175134db45e8https://doi.org/10.1007/s00264-025-06412-8
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Also Consider

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

  1. 1Hip fractures in patients older than 75 years old: Retrospective analysis for prognostic factors2015 · 46 citations
  2. 2Managing Mortality: Key Factors Influencing Hemiarthroplasty Outcomes in Geriatric Patients with Proximal Femur Fractures2025 · 1 citations
  3. 3Analysis of risk factors affecting mortality in elderly patients operated on for hip fractures: A retrospective comparative study2021 · 16 citations
  4. 4Risk factors affecting mortality and patient survival in patients above 60 years undergoing hemiarthroplasty due to hip fracture2022 · 1 citations
  5. 5Risk factors for mortality and survival rates in elderly patients undergoing hemiarthroplasty for hip fracture2020 · 33 citations