• Ahmed Abdul Hadi Harb Nasser, Rohan Prakash, Charles Handford, Khabab Osman, Govind Singh Chauhan, Rajpal Nandra, Ansar Mahmood, Varun Dewan, Jerome Davidson, Mohammed Al-Azzawi, Christian Smith, Mothana Gawad, Ioannis Palaiologos, Rory Cuthbert, Warran Wignadasan, Daniel Banks, James Archer, Abdulrahman Odeh, Thomas Moores, Muaaz Tahir, Margaret Brooks, Gurdeep Biring, Stevan Jordan, Zain Elahi, Mohammed Shaath, Manoj Veettil, Chiranjit De, Mohit Bansal, Akshdeep Bawa, Ahmed Mattar, Varun Tandra, Audrina Daadipour, Ahmed Taha, Shafat Gangoo, Sriram Srinivasan, Mandishona Tarisai, Basil Budair, Krishna Subbaraman, Farrukh Khan, Austin Gomindes, Arjun Samuel, Niel Kang, Karan Kapur, Elizabeth Mainwaring, Hannah Bridgwater, Andre Lo, Usman Ahmed, Tahir Khaleeq, Ahmed El-Bakoury, Ramy Rashed, Hazem Hosny, Rathan Yarlagadda, Jonathan Keenan, Ahmed Hamed, Bryan Riemer, Arham Qureshi, Vatsal Gupta, Matthew Waites, Sabri Bleibleh, David Westacott, Jonathan Phillips, Jamie East, Daniel Huntley, Saqib Masud, Yusuf Mirza, Sandeep Mishra, David Dunlop, Mohamed Khalefa, Balakumar Balasubramanian, Mahesh Thibbaiah, Olivia Payton, James Berstock, Krisna Deano, Khaled Sarraf, Kartik Logishetty, George Lee, Hariharan Subbiah-Ponniah, Nirav Shah, Aakaash Venkatesan, James Cheseldene-Culley, Joseph Ayathamattam, Samantha Tross, Sukhwinder Randhawa, Faisal Mohammed, Ramla Ali, Jonathan Bird, Kursheed Khan, Muhammad Adeel Akhtar, Andrew Brunt, Panagiotis Roupakiotis, Padmanabhan Subramanian, Nelson Bua, Mounir Hakimi, Samer Bitar, Majed Al Najjar, Ajay Radhakrishnan, Charlie Gamble, Andrew James, Catherine Gilmore, Dan Dawson, Rajesh Sofat, Mohamed Antar, Aashish Raghu, Sam Heaton, Waleed Tawfeek, Christerlyn Charles, Henry Burnand, Sean Duffy, Luke Taylor, Laura Magill, Rita Perry, Michala Pettitt, Kelvin Okoth, and Thomas Pinkney.
• The Birmingham Orthopaedic Network, Specialty Registrar, The Birmingham Orthopaedic Training Program, The Royal Orthopaedic Hospital, Birmingham B31 2AP, UK. Electronic address: Ahmed.Nasser@nhs.net.
• Injury. 2023 Dec 1; 54 (12): 111152111152.

IntroductionPeriprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip.MethodsUsing a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period. Univariate and multivariable logistic regression analyses were performed to study the independent correlation between patient, fracture, and treatment factors on mortality.ResultsA total of 1,109 patients were included. The in-hospital mortality rate was 5.3%. Multivariable analyses suggested that age, male sex, abbreviated mental test score (AMTS), pneumonia, renal failure, history of peripheral vascular disease (PVD) and deep surgical site infection were each independently associated with mortality. Each yearly increase in age independently correlates with a 7% increase in mortality (OR 1.07, p=0.019). The odds of mortality was 2.99 times higher for patients diagnosed with pneumonia during their hospital stay [OR 2.99 (95% CI 1.07-8.37) p=0.037], and 7.25 times higher for patients that developed renal failure during their stay [OR 7.25 (95% CI 1.85-28.47) p=0.005]. Patients with history of PVD have a six-fold greater mortality risk (OR 6.06, p=0.003). Mode of treatment was not a significant predictor of mortality.ConclusionThe in-hospital mortality rate of PPFs around the hip exceeds 5%. The fracture subtype and mode of management are not independent predictors of mortality, while patient factors such as age, AMTS, history of PVD, pneumonia, and renal failure can independently predict mortality. Peri-operative optimisation of modifiable risk factors such as lung and kidney function in patients with PPFs around the hip during their hospital stay is of utmost importance.Copyright © 2023 Elsevier Ltd. All rights reserved.

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