Short-term risk factors for a second hip fracture in a UK population
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ORIGINAL ARTICLE • HIP - TRAUMA
Short‑term risk factors for a second hip fracture in a UK population Hassaan Q. Sheikh1 · Fahad S. Hossain1 · Sayeed Khan2 · Mohammad Usman3 · Harish Kapoor1 · Adeel Aqil1 Received: 9 January 2019 / Accepted: 4 March 2019 © The Author(s) 2019
Abstract Introduction A hip fracture carries significant morbidity and mortality—a second fracture of the contralateral hip carries even higher complications. Most second hip fractures occur within 48 months of the first. The aim of this study was to comprehensively analyse all identifiable variables that may increase the risk of a contralateral hip fracture within this time period. Methods We retrospectively analysed 1242 consecutive patients with hip fractures presenting to our institution. All patientrelated, surgery-related and inpatient variables were collected from the index admission. We then identified patients with a subsequent contralateral hip fracture in the following 2 years. Univariate and multivariate analyses were performed to identify risk factors associated with a second fracture. Results A total of 66 patients (5.3%) had a contralateral hip fracture in the 2 years following initial hip fracture. Mean age at first presentation was 81 years, and mean time to second fracture was 305 days. Following multivariate analysis, the patients at highest risk of a second fracture were those with dementia, acute inpatient chest infection, urinary tract infection and multiple comorbidities as measured by the Charlson score. Discharge destination after initial fracture was not associated with the risk of a second fracture. Conclusions We have identified a number of discrete risk factors that are associated with a short- to medium-term risk of contralateral hip fracture that may be useful in screening for patients at risk and provide them with focused medical rehabilitation. Keywords Hip fracture · Re-fracture · Second fracture · Epidemiology · Proximal femur fracture · Osteoporosis · Risk factors
Introduction Hip fractures are of the commonest sequelae of osteoporosis with significantly poor patient outcomes and a massive cost burden to healthcare institutions [1]. Furthermore, they are associated with high mortality rates and development of secondary complications [2, 3]. Consequently, there is plenty of literature surrounding the epidemiology and complications of hip fractures. There are, however, fewer studies focusing on the patient population with a contralateral hip fracture following an initial hip fracture. Patients sustaining a first hip fracture are at 11–15% increased 10-year risk of * Hassaan Q. Sheikh [email protected] 1
Leeds Teaching Hospitals, Great George St, Leeds LS1 3EX, UK
2
Barnsley Hospital Trust, Gawber Rd, Barnsley S75 2EP, UK
3
Bradford Teaching Hospitals, Duckworth Ln, Bradford BD9 6RJ, UK
second hip fracture [4]. They also have 2.5 times increased risk of other types of fracture [5]. Following a second hip fracture, patients are less likely to maintain their walking ability and social i
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