The risk of complications after hip fracture
Abstract
Aims: The risk of mortality after a hip fracture has been extensively investigated, but there is little high-quality information available dealing with the overall risk of complications. The aim of this study was to report the risk of complications in the first 120 days after a hip fracture. Methods: This was a multicentre, prospective cohort study of patients aged > 60 years with a hip fracture, involving 77 hospitals in England, Wales, and Northern Ireland, between January 2015 and 2022. The primary outcomes of interest were mortality and surgery-specific and general complications, at 120 days postoperatively. Results: A total of 24,523 patients with a hip fracture were enrolled. The 120-day risk of mortality was 12.4% (95% CI 12.0 to 12.8). The 120-day risks of surgery-specific complications were: for dislocation, 1.5% (95% CI 1.3 to 1.7); failure of fixation, 1.0% (95% CI 0.8 to 1.2); for peri-implant or periprosthetic fracture, 0.3% (95% CI 0.3 to 0.4); for reoperation for any indication, 2.7% (95% CI 2.5 to 2.9); and for surgical site infection, 3.4% (95% CI 3.2 to 3.6). The 120-day risks of general complications were: for acute kidney injury, 3.4% (95% CI 3.1 to 3.6); for the requirement of a blood transfusion, 7.0% (95% CI 6.7 to 7.3); for lower respiratory tract infection, 9.1% (95% CI 8.7 to 9.4); for urinary tract infection, 7.0% (95% CI 6.7 to 7.3); for cerebrovascular accident, 0.7% (95% CI 0.6 to 0.8); for myocardial infarction, 0.7% (95% CI 0.6 to 0.9); and for venous thromboembolism, 1.8% (95% CI 1.6 to 2.0). Conclusions: Although the risk of mortality has declined in recent years, older patients with a hip fracture remain at a high risk of surgery-specific and general complications.
Author
Goh, En Lin
Png, May Ee
Metcalfe, David
Achten, Juul
Appelbe, Duncan
Griffin, Xavier L
Cook, Jonathan A
Costa, Matthew L
Barrett, Michael
Hull, Peter
Melling, David
Kosy, Jonathan
Charalambous, Charalambous P
Keast-Butler, Oliver
Magill, Paul
Yarlagadda, Rathan
Vashista, Girish
Savaridas, Terence
Sturridge, Seb
Smith, Graham
Dasari, Kishore
Bhaskar, Deepu
Bajada, Stefan
Bigsby, Ewan
Mahmood, Ansar
Dunbar, Mark
Jimenez, Andrea
Wood, Ryan
Penny, James
Eardley, William
Handley, Robert
Srinivasan, Suresh
Gee, Matt
Kulkarni, Ashwin
Davison, John
Maqsood, Mohammad
Sharma, Amit
Peach, Chris
Sheeraz, Ahsan
Page, Piers
Kelly, Andrew
McNamara, Iain
Longstaff, Lee
Reed, Mike
Moppett, Iain
Sorial, Ayman
Joachim, Theophilus
Ng, Aaron
Gallagher, Kieran
Farrar, Mark
Ghande, Ad
Bird, Jonathan
Rajagopalan, Shyam
McAndrew, Andrew
Sloan, Andrew
Middleton, Rory
Dos Remedios, Ian
McClelland, Damian
Rogers, Benedict
Berstock, James
Bhatnagar, Sharad
Diamond, Owen
Fearon, Paul
Gill, Inder
Dunlop, Doug
Chesser, Tim
Acharya, Mehool
Sree, Deepak
Craik, Johnathan
Hutchinson, David
Johnson, David
Elgalli, Mosab
Dixon, Paul
Ellapparadja, Pregash
Slater, Guy
Kozdryk, Jakub
Young, Jonathan
Ollivere, Ben
Mohanty, Khitish
Faisal, Mohammad
Clark, Callum
Dhinsa, Baljinder
Malek, Ibrahim
Heaton, Sam
Blocker, Oliver
Theivendran, Kanthan
Theivendran, Kanthan
Theivendran, Kanthan
Png, May Ee
Metcalfe, David
Achten, Juul
Appelbe, Duncan
Griffin, Xavier L
Cook, Jonathan A
Costa, Matthew L
Barrett, Michael
Hull, Peter
Melling, David
Kosy, Jonathan
Charalambous, Charalambous P
Keast-Butler, Oliver
Magill, Paul
Yarlagadda, Rathan
Vashista, Girish
Savaridas, Terence
Sturridge, Seb
Smith, Graham
Dasari, Kishore
Bhaskar, Deepu
Bajada, Stefan
Bigsby, Ewan
Mahmood, Ansar
Dunbar, Mark
Jimenez, Andrea
Wood, Ryan
Penny, James
Eardley, William
Handley, Robert
Srinivasan, Suresh
Gee, Matt
Kulkarni, Ashwin
Davison, John
Maqsood, Mohammad
Sharma, Amit
Peach, Chris
Sheeraz, Ahsan
Page, Piers
Kelly, Andrew
McNamara, Iain
Longstaff, Lee
Reed, Mike
Moppett, Iain
Sorial, Ayman
Joachim, Theophilus
Ng, Aaron
Gallagher, Kieran
Farrar, Mark
Ghande, Ad
Bird, Jonathan
Rajagopalan, Shyam
McAndrew, Andrew
Sloan, Andrew
Middleton, Rory
Dos Remedios, Ian
McClelland, Damian
Rogers, Benedict
Berstock, James
Bhatnagar, Sharad
Diamond, Owen
Fearon, Paul
Gill, Inder
Dunlop, Doug
Chesser, Tim
Acharya, Mehool
Sree, Deepak
Craik, Johnathan
Hutchinson, David
Johnson, David
Elgalli, Mosab
Dixon, Paul
Ellapparadja, Pregash
Slater, Guy
Kozdryk, Jakub
Young, Jonathan
Ollivere, Ben
Mohanty, Khitish
Faisal, Mohammad
Clark, Callum
Dhinsa, Baljinder
Malek, Ibrahim
Heaton, Sam
Blocker, Oliver
Theivendran, Kanthan
Theivendran, Kanthan
Theivendran, Kanthan
Citations
Altmetric:
Date
2025-03-01
Type
Article
Subject
Orthopaedics
Citation
Goh EL, Png ME, Metcalfe D, Achten J, Appelbe D, Griffin XL, Cook JA, Costa ML; WHiTE Investigators; Barrett M, Hull P, Melling D, Kosy J, Charalambous CP, Keast-Butler O, Magill P, Yarlagadda R, Vashista G, Savaridas T, Sturridge S, Smith G, Dasari K, Bhaskar D, Bajada S, Bigsby E, Mahmood A, Dunbar M, Jimenez A, Wood R, Penny J, Eardley W, Handley R, Srinivasan S, Gee M, Kulkarni A, Davison J, Maqsood M, Sharma A, Peach C, Sheeraz A, Page P, Kelly A, McNamara I, Longstaff L, Reed M, Moppett I, Sorial A, Joachim T, Ng A, Gallagher K, Farrar M, Ghande A, Bird J, Rajagopalan S, McAndrew A, Sloan A, Middleton R, Dos Remedios I, McClelland D, Rogers B, Berstock J, Bhatnagar S, Diamond O, Fearon P, Gill I, Dunlop D, Chesser T, Acharya M, Sree D, Craik J, Hutchinson D, Johnson D, Elgalli M, Dixon P, Ellapparadja P, Slater G, Kozdryk J, Young J, Ollivere B, Mohanty K, Faisal M, Clark C, Dhinsa B, Malek I, Heaton S, Blocker O, Theivendran K. The risk of complications after hip fracture. Bone Joint J. 2025 Mar 1;107-B(3):362-367. doi: 10.1302/0301-620X.107B3.BJJ-2024-0858.R1
Journal / Source Title
The Bone & Joint Journal
DOI
PMID
Publisher
British Editorial Society of Bone and Joint Surgery