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Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

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Abstract

Purpose

Adverse events associated with the use of bone cement for fixation of prostheses is a known complication. Due to inconclusive results in studies of hip fracture patients treated with cemented and uncemented hemiprostheses, this study was initiated.

Methods

Our study is based on data reported to the Norwegian Hip Fracture Register on 11,210 cervical hip fractures treated with hemiprostheses (8,674 cemented and 2,536 uncemented).

Results

Significantly increased mortality within the first day of surgery was found in the cemented group (relative risk 2.9, 95 % confidence interval 1.6–5.1, p=0.001). The finding was robust giving the same results after adjusting for independent risk factors such as age, sex, cognitive impairment and comorbidity [American Society of Anesthesiologists (ASA) score]. For the first post-operative day the number needed to harm was 116 (one death for every 116 cemented prosthesis). However, in the most comorbid group (ASA worse than 3), the number needed to harm was only 33.

Conclusions

We found increased mortality for the cemented hemiprosthesis the first post-operative day compared to uncemented procedures. This increased risk is closely related to patient comorbidity estimated by the patient’s ASA score.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Innlandet Hospital Trust, Elverum, Norway

    Ove Talsnes & Ola E. Dahl

  2. Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway

    Tarjei Vinje, Jan Erik Gjertsen, Lars B. Engesæter & Valborg Baste

  3. Centre of Medical Science, Education and Innovation, Innlandet Hospital Trust, Brumunddal, Norway

    Ola E. Dahl

  4. Thrombosis Research Institute, London, UK

    Ola E. Dahl

  5. Biostatistics and Epidemiology Unit, Oslo University Hospital, Oslo, Norway

    Are Hugo Pripp

  6. Department of Orthopaedics, Oslo University Hospital, Oslo, Norway

    Olav Reikerås

Authors
  1. Ove Talsnes
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  2. Tarjei Vinje
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  3. Jan Erik Gjertsen
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  4. Ola E. Dahl
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  5. Lars B. Engesæter
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  6. Valborg Baste
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  7. Are Hugo Pripp
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  8. Olav Reikerås
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Correspondence to Ove Talsnes.

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Talsnes, O., Vinje, T., Gjertsen, J.E. et al. Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients. International Orthopaedics (SICOT) 37, 1135–1140 (2013). https://doi.org/10.1007/s00264-013-1851-3

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  • DOI: https://doi.org/10.1007/s00264-013-1851-3

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