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

doi:10.1302/0301-620X.101B1.BJJ-2018-0601.R2

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 journal › Article (Academic Journal) › peer-review

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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 language	English
Pages (from-to)	83-91
Number of pages	9
Journal	Bone and Joint Journal
Volume	101-B
Issue number	1
Early online date	2 Jan 2019
DOIs	https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0601.R2
Publication status	Published - Jan 2019

Research Groups and Themes

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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10.1302/0301-620X.101B1.BJJ-2018-0601.R2

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Whitehouse, M., Berstock, J. R., Kelly, M., Gregson, C., Judge, A., Sayers, A., & Chesser, T. J. (2019). 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. Bone and Joint Journal, 101-B(1), 83-91. https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0601.R2

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title = "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",

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.",

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",

author = "Michael Whitehouse and Berstock, \{James R\} and Michael Kelly and Celia Gregson and Andrew Judge and Adrian Sayers and Chesser, \{Timothy J\}",

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doi = "10.1302/0301-620X.101B1.BJJ-2018-0601.R2",

language = "English",

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pages = "83--91",

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publisher = "British Editorial Society of Bone and Joint Surgery",

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Whitehouse, M, Berstock, JR, Kelly, M, Gregson, C , Judge, A , Sayers, A & Chesser, TJ 2019, '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', Bone and Joint Journal, vol. 101-B, no. 1, pp. 83-91. https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0601.R2

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. / Whitehouse, Michael; Berstock, James R; Kelly, Michael et al.
In: Bone and Joint Journal, Vol. 101-B, No. 1, 01.2019, p. 83-91.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Higher 30-day mortality associated with the use of intramedullary nails compared with sliding hip screws for the treatment of trochanteric hip fractures

T2 - a prospective national registry study

AU - Whitehouse, Michael

AU - Berstock, James R

AU - Kelly, Michael

AU - Gregson, Celia

AU - Judge, Andrew

AU - Sayers, Adrian

AU - Chesser, Timothy J

PY - 2019/1

Y1 - 2019/1

N2 - 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.

AB - 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.

KW - Aged

KW - Aged, 80 and over

KW - Bone Nails

KW - Bone Screws

KW - Female

KW - Fracture Fixation, Intramedullary/instrumentation

KW - Hip Fractures/mortality

KW - Humans

KW - Length of Stay/statistics & numerical data

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - United Kingdom/epidemiology

UR - https://www.scopus.com/pages/publications/85059379440

U2 - 10.1302/0301-620X.101B1.BJJ-2018-0601.R2

DO - 10.1302/0301-620X.101B1.BJJ-2018-0601.R2

M3 - Article (Academic Journal)

C2 - 30601043

SN - 2049-4394

VL - 101-B

SP - 83

EP - 91

JO - Bone and Joint Journal

JF - Bone and Joint Journal

IS - 1

ER -

Whitehouse M, Berstock JR, Kelly M, Gregson C , Judge A , Sayers A et al. 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. Bone and Joint Journal. 2019 Jan;101-B(1):83-91. Epub 2019 Jan 2. doi: 10.1302/0301-620X.101B1.BJJ-2018-0601.R2

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

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