• Injury · Oct 2024

    Multicenter Study

    Predictors of outcomes after internal fixation of periprosthetic femoral hip fractures Subgroup analysis of the peri-implant and peri-prosthetic fractures Spanish registry (PIPPAS).

    • José Vicente Andrés-Peiró, Josep Nomdedéu, Héctor J Aguado, Diego González-Morgado, Joan Minguell-Monyart, Nayana Joshi-Jubert, Jordi Teixidor-Serra, Jordi Tomàs-Hernández, Jordi Selga-Marsà, Yaiza García-Sánchez, David C Noriega-González, Elvira Mateos-Álvarez, Adela Pereda-Manso, M Carmen Cervera-Díaz, Patricia Balvis-Balvis, Ángela García-Pérez, Mónica Rodríguez-Arenas, Manuel Castro-Menéndez, Jesús Moreta, Beatriz Olías-López, Patricia Amaya-Espinosa, Juan Boluda-Mengod, Leopoldo Bárcena-Goitilandia, José Antonio Blas-Dobón, Patricio Freile-Pazmiño, Pablo Castillón, Lucía Lanuza-Lagunilla, Julián Cabria-Fernández, José Valle-Cruz, Javier García-Coiradas, César Bonome-Roel, María de Los Ángeles Cano-Leira, Antonio Benjumea-Carrasco, Marcos Chico-García, Alexis Fernández-Juan, Eladio Saura-Sánchez, Plácido Sánchez-Gómez, Francisco Javier Ricón-Recarey, Elena María García-García, Isabel Medrano-Morte, Francisco Cuadrado-Abajo, María I Pérez-Núñez, Sara García-González, Pedro Del Pozo-Manrique, Francisco Manuel García-Navas-García, Ester García-Paredero, Ainhoa Guijarro-Valtueña, Inés Navas-Pernía, Miquel Videla-Cés, Josep M Muñoz-Vives, Jordi Querolt-Coll, Guillermo Triana-López de Santamaría, Teresa Serra-Porta, M Carmen Carrasco-Becerra, Silvia Pena-Paz, Víctor Otero-Naveiro, Fátima Fernández-Dorado, Amaia Martínez-Menduiña, Elena Galián-Muñoz, José M Hernández, Marina Renau-Cerrillo, Borja Campuzano-Bitterling, Anna Carreras-Castañer, Marian Vives-Barquiel, Pilar Camacho-Carrasco, Montsant Jornet-Gibert, Adrián Muñoz-Vicente, Carla Gámez-Asunción, Nuria Plaza-Salazar, Jennifer Benito-Santamaría, Alejandro Cuenca-Copete, Laura Alonso-Viana, Juan Mingo-Robinet, Ricardo Briso-Montiano, Amaya Barbería-Biurrun, Laura Chouza-Montero, Cristina Ojeda-Thies, Eliam Ajuria-Fernández, Rebeca Díaz-Suárez, Alfons Gasset-Teixidor, Andrea Domínguez-Ibarrola, Javier Gosálbez, Imanol Pérez-Hevia, Luís Riera-Álvarez, Adrián Roche-Albero, María Macho-Mier, Guillermo Criado-Albillos, Hugo Gabriel Cabello-Benavides, Jorge Cunchillos-Pascual, José Carlos Saló-Cuenca, Jordi Espona-Roselló, César Salamanca-Ontiveros, Pablo García-Portabella, Jorge Martínez-Íñiguez Blasco, Paloma Sevilla-Ortega, Juan Ramón Cano-Porras, Santos Martínez-Díaz, Guido Sebastián Carabelli, Pablo Slullitel, Ignacio Astore, Carlos Hernández-Pascual, Javier Marín-Sánchez, Julio C Córdova-Peralta, Natalia Sánchez-Hernández, Guillermo García-García, Alfredo Rodríguez-Gangoso, José María Pérez-Sánchez, Ana Piñeiro-Borrero, Alfonso Mandía-Martínez, Julio De Caso-Rodríguez, Miguel Benito-Mateo, Antonio D Murillo-Vizuete, Gaspar De La Herrán-Núnez, Nahikari Nunes-Ugarte, Nicolás Elizalde Pérez-Salazar, María De Sande-Díaz, Xoan D García-Fuentes, Unai García de Cortázar-Antolín, Daniel Escobar Sánchez, and PIPPAS Study Group.
    • Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System research group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
    • Injury. 2024 Oct 1; 55 (10): 111715111715.

    PurposeTo identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems.MethodsProspective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay).ResultsOne-year mortality was 16.2%. Age-adjusted Charlson Comorbidity Index score (OR=1.17; 95%CI=1.03-1.33)), Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) score (OR=1.16; 1.06-1.28), prosthetic dysfunction (OR=1.90; 1.00-3.61), and postoperative medical complications (OR=1.97; 1.06-3.68) were predictors of mortality. Patients with prior prosthetic dysfunction, lower Pfeiffer SPMSQ scores, Vancouver A fractures, and fractures fixed only using cerclages were at higher risk of local complications, which occurred in 9.3% of cases. Medical (OR=1.81; 1.05-3.13) and local complications (OR=5.56; 2.42-3.13) emerged as consistent risk factors for new institutionalization. Average hospitalization time was 13.9±9.2 days. Each day of fixation delay led to an average 1.4-day increase in total hospitalization.ConclusionFrail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization.Copyright © 2024. Published by Elsevier Ltd.

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