One-Year Mortality Rates Following Fracture of the Femoral Neck Treated With Hip Arthroplasty in an Aging Saudi Population: A Trauma Center Experience

Abstract

Introduction: Femoral neck fracture is a common problem in elderly patients, and it is managed with either total hip arthroplasty or hemiarthroplasty with very good outcomes. However, the reported 1-year mortality rate is as high as 33%. Material and Methods: This study was a retrospective cohort study. The electronic patient records were searched for all physiologically old patients with displaced femoral neck fractures that were managed with either hemiarthroplasty or total hip arthroplasty. The primary aim of this study was to estimate morbidity and mortality rates at 30 days and 1 year. The secondary outcome was to determine major complications and factors influencing mortality. Results: From January 2017 to December 2018, a total of 99 patients were included in the study. Of those, 57 were female patients. The mortality rate was 15.2%. The significant predictors of death included the age at the time of surgery, readmission within 30 days of initial admission, acute renal impairment, and the need for preoperative medical intervention. Patients treated with total hip arthroplasty had lower mortality rates than those treated with hemiarthroplasty ( P = .017). Discussion: To the best of our knowledge, this is the first study conducted in Saudi Arabia to report detailed perioperative-related complications and outcomes following neck of femur fractures. The results of our study confirm the persistently high morbidity and mortality associated with this patient group. Conclusion: Efforts should be aimed at optimizing preoperative medical management, which is vital to ensure early identification of medically unfit patients.

Characteristics of Elderly Hip Fracture Patients in Jordan: A Multicenter Epidemiological Study

“… 12 , 24 Recent studies documented the 1-year mortality rate of hip fractures in the nearby Arab countries (such as Saudi Arabia and Lebanon); it is ranging from 10 to 25%. 16 , 17 , 19 , 25 , 26 Our findings showed a 12.8% 1-year mortality rate, which is at the lower limit of the rates of nearby Arab countries.…”

Functional Outcomes of Anterior-Based Muscle Sparing Approach Compared to Direct Lateral Approach for Total HIP Arthroplasty Following Acute Femoral Neck Fractures

“…In our opinion, the statistical significance of both earlier hospital discharge and 3 months TUG test can play a critical role for this specific population of elderly patients with FNFs. As already extensively reported in the literature, [33][34][35][36] patients have a very high early mortality rate independent from clinical scores (HHS and OHS, in particular), therefore an early hospital discharge and a faster TUG test recovery could potentially be better indicators of the clinical status of the patients more than clinical scores by themselves. However, critical benefits for such a population of elderly patients with FNFs did not last more than 3 months after surgery, meaning that neither the OHS nor HHS differences reached a significant minimal clinically important difference.…”

Incidence of silent venous thromboembolism after total hip arthroplasty: A comparison of rivaroxaban and enoxaparin

“…Moreover, assessments of the invasiveness of CTV and the accuracy of the Well score should be considered in future studies, based on which routine US should be performed as a less invasive test for screening patients with high Well scores. Likewise, the patients treated with THA for reasons other than osteoarthrits, such as the neck or femoral fractures 33 and ochronotic arthropathy, 34 should be included in future studies to examine the incidence of silent DVT and the effect of different anticoagulants.…”