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Most hip fracture patients do not have medical complications following surgery

Each year, more than 225,000 people aged 50 or older in the United States suffer a hip fracture. Most (81 percent) patients undergoing hip fracture repair surgery suffer no postoperative complications, according to a study supported in part by the Agency for Healthcare Research and Quality (HS07322).

The researchers retrospectively studied data on complications and deaths from the medical records of 8,930 patients 60 years of age or older who underwent hip fracture repair surgery in one of 20 academic, community, or Veterans Affairs hospitals. The study population was elderly (mean age 80 or older), primarily female (79 percent), white (87 percent), and living at home at the time of the fracture (73 percent).

Only 1,737 (19 percent) of patients undergoing hip fracture repair surgery had postoperative medical complications. Among this group, cardiac and pulmonary complications were most frequent (8 and 4 percent, respectively). Serious cardiac and pulmonary complications occurred with equal frequency (2 and 3 percent, respectively). Death rates within 30 days and 1 year of surgery were 22 percent and 36 percent, respectively, for cardiac complications and 17 percent and 44 percent for pulmonary complications. Complications and death occurred significantly earlier for serious cardiac than for serious pulmonary complications (1 vs. 4 days and 2 vs. 8 days, respectively), but length of hospital stay was similar for patients surviving these complications (13 and 12 days, respectively).

Other complications included gastrointestinal tract bleeding (2 percent), combined cardiopulmonary complications (1 percent), venous thromboembolism (1 percent), and transient ischemic attack or stroke (1 percent). Renal failure and septic shock were rare. Overall in-hospital death was 3.3 percent. Most patients had only one complication, but 12 percent had multiple complications. Patients with multiple complications and renal failure had the highest in-hospital mortality rates (29-38 percent). The researchers conclude that most elderly patients have an uncomplicated course after hip fracture repair.

See "Medical complications and outcomes after hip fracture repair," by Valerie A. Lawrence, M.D., Susan G. Hilsenbeck, Ph.D., Helaine Noveck, M.P.H., and others, in the October 14, 2002 Archives of Internal Medicine 162, pp. 2053-2057.

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