Higher 30-day mortality associated with the use of intramedullary nails compared with sliding hip screws for the treatment of trochanteric hip fractures: a prospective national registry study

Michael Whitehouse, James R Berstock, Michael Kelly, Celia Gregson, Andrew Judge, Adrian Sayers, Timothy J Chesser

Research output: Contribution to journalArticle (Academic Journal)peer-review

13 Citations (Scopus)
247 Downloads (Pure)

Abstract

AIMS: The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality.

PATIENTS AND METHODS: Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors.

RESULTS: The use of short and long intramedullary nails was associated with an increase in 30-day mortality (adjusted odds ratio (OR) 1.125, 95% confidence interval (CI) 1.040 to 1.218; p = 0.004) compared with the use of sliding hip screws (12.5% increase). If this were causative, it would represent 98 excess deaths over the four-year period of the study and one excess death would be caused by treating 112 patients with an intramedullary nail rather than a sliding hip screw.

CONCLUSION: There is a 12.5% increase in the risk of 30-day mortality associated with the use of an intramedullary nail compared with a sliding hip screw in the treatment of a trochanteric fractures of the hip.

Original languageEnglish
Pages (from-to)83-91
Number of pages9
JournalBone and Joint Journal
Volume101-B
Issue number1
Early online date2 Jan 2019
DOIs
Publication statusPublished - Jan 2019

Structured keywords

  • Centre for Surgical Research

Keywords

  • Aged
  • Aged, 80 and over
  • Bone Nails
  • Bone Screws
  • Female
  • Fracture Fixation, Intramedullary/instrumentation
  • Hip Fractures/mortality
  • Humans
  • Length of Stay/statistics & numerical data
  • Male
  • Middle Aged
  • Prospective Studies
  • United Kingdom/epidemiology

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