Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone: results from a United Kingdom teaching hospital

Arch Orthop Trauma Surg. 2016 Apr;136(4):463-7. doi: 10.1007/s00402-016-2422-z. Epub 2016 Feb 18.

Abstract

Introduction: A proportion of patients sustaining hip fractures present with a concomitant fracture. We aimed to evaluate the relationship between patient characteristics and clinical outcomes, in those with a hip and concomitant fracture compared with those sustaining a hip fracture alone from a clinical service registry.

Method: Cross-sectional study using data obtained from a clinical service registry (Nottingham Hip Fracture Database) on patients aged 50 and above who suffered a hip fracture between 1/1/2003 and 31/12/2012. Data was collected on patient demographics, fracture information and healthcare outcomes.

Results: 7338 patients of which 75 % were female (mean age 82 (SD 9.4), had a hip fracture with 334 (4.6 %) patients having a concomitant fracture. The majority (58 %) were distal radius or proximal humeral fractures. Only females (p = 0.002), those taking three or fewer medications (p = 0.018) and those on long term steroids (p = 0.048) were more likely to suffer a concomitant fracture. There was no difference in mortality, rates of postoperative complication, intensive care unit or care home admission between both groups. Patients with a concomitant fracture have a 16 % longer average length of stay in hospital (mean difference 1.16; 95 % CI 1.07-1.25, p < 0.001).

Conclusions: Patients with concomitant fractures have similar patient characteristics, except gender, polypharmacy and long term steroid use; and outcomes to those presenting with hip fracture alone, except a longer average inpatient stay.

Keywords: Bone fragility; Concomitant fracture; Fall; Fragility fractures; Hip fractures; Osteoporosis; Osteoporotic fractures.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Hip Fractures* / diagnosis
  • Hip Fractures* / surgery
  • Hospitals, Teaching
  • Humans
  • Male
  • Middle Aged
  • Multiple Trauma* / diagnosis
  • Multiple Trauma* / surgery
  • Osteoporotic Fractures* / diagnosis
  • Osteoporotic Fractures* / surgery
  • Postoperative Complications
  • Radius Fractures* / diagnosis
  • Radius Fractures* / surgery
  • Shoulder Fractures* / diagnosis
  • Shoulder Fractures* / surgery
  • Treatment Outcome
  • United Kingdom