Key result
Reoperation after hip fracture was associated with a 10-year mortality rate of 62.9% versus 79.8% in non-reoperated patients, and increased acute care costs by 31% compared to primary operations.
Cohort (n=490)
No
Reoperations after hip fracture are common (14.3%), occur mostly within the first year, and significantly increase acute care costs.
Reoperations raise acute hip fracture costs nearly 20%; leaves open whether prevention efforts improve survival in unselected cohorts.
BACKGROUND AND AIMS: Reoperations after operative treatment of hip fracture patients may be associated with higher costs and inferior survival. We examined the acute hospital costs, long-term reoperation rates, and survival of patients with a new hip fracture. MATERIALS AND METHODS: A total of 490 consecutive new hip fracture patients treated at a single center between 31 December 2004 and 6 December 2006 were analyzed retrospectively. Fractures were classified according to Garden and AO. All medical records were checked manually. The costs of reoperations were calculated using the diagnosis-related groups (DRG)-based prices. Survival analysis was performed using the life-table method. The follow-up time was 10 years. RESULTS: In all, 70/490 patients (14.3%) needed reoperations. Of all reoperations, 34.2% were performed during the first month and 72.9% within 1 year after the primary operation. The hemiarthroplasty dislocation rate was 8.5%, and mechanical failures of osteosynthesis occurred in 6.2%. Alcohol abuse was associated with a heightened risk of reoperation. The mean direct costs of primary fracture care were lower than the mean costs of reoperations (€7500 vs €9800). The mortality rate at 10 years was 79.8% among non-reoperated patients and 62.9% among reoperated patients. CONCLUSIONS: According to our hypothesis, the cost per patient of reoperation in acute care was 31% higher than the corresponding cost of a primary operation. Reoperations increased the overall immediate costs of index fractures by nearly 20%. One-third of all reoperations were performed during the first month and almost 75% within 1 year after the primary operation.
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Tiihonen et al. (2018) conducted a cohort in Hip fracture (n=490). Reoperation vs. No reoperation was evaluated on Mortality rate at 10 years. Reoperation after hip fracture was associated with a 10-year mortality rate of 62.9% versus 79.8% in non-reoperated patients, and increased acute care costs by 31% compared to primary operations.
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