Trends and benefits of early hip arthroplasty for femoral neck fracture in china: a national cohort study-Reference-Cited by-同舟云学术

Trends and benefits of early hip arthroplasty for femoral neck fracture in china: a national cohort study

Published:2024-02-05 Issue: Volume: Page:
ISSN:1743-9159
Container-title:International Journal of Surgery
language:en
Short-container-title:

Author:

Wang Yuqing¹,Jiang Qiao¹,Long Huizhong¹,Chen Hu²,Wei Jie³⁴⁵⁶,Li Xiaoxiao⁴⁵,Wang Haibo⁷⁸,Xie Dongxing¹,Zeng Chao¹⁴⁵⁹,Lei Guanghua¹⁴⁵⁹

Affiliation:

1. Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China

2. Tibet Autonomous Region People’s Hospital, Lhasa, Tibet, China

3. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China

4. Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China

5. Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China

6. Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China

7. China Standard Medical Information Research Center, Shenzhen, Guangdong, China

8. Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China

9. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

Abstract

Background: Limited studies have examined the benefits of early arthroplasty within 48 hours from admission to surgery for femoral neck fractures (FNFs). Using the national inpatient database, we aimed to investigate the trends in early arthroplasty within 48 hours for FNFs in China and to assess its effect on in-hospital complications and 30-day readmission patterns. Materials and Methods: This was a retrospective cohort study. Patients receiving primary total hip arthroplasty (THA) or hemiarthroplasty (HA) for FNFs in the Hospital Quality Monitoring System between 2013 and 2019 were included. After adjusting for potential confounders with propensity score matching, a logistic regression model was performed to compare the differences in in-hospital complications (i.e., in-hospital death, pulmonary embolism [PE], deep vein thrombosis [DVT], wound infection, and blood transfusion), rates and causes of 30-day readmission between early and delayed arthroplasty. Results: During the study period, the rate of early THA increased from 18.0% to 19.9%, and the rate of early HA increased from 14.7% to 18.4% (P<0.001). After matching, 11,731 pairs receiving THA and 13,568 pairs receiving HA were included. Compared with delayed THA, early THA was associated with a lower risk of PE (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.30-0.88), DVT (OR 0.59, 95% CI 0.50-0.70), blood transfusion (OR 0.62, 95% CI 0.55-0.70), 30-day readmission (OR, 0.82; 95% CI, 0.70 to 0.95), and venous thromboembolism-related readmission (OR, 0.50; 95% CI, 0.34 to 0.74). Similarly, early HA was associated with a lower risk of DVT (OR 0.70, 95% CI 0.61-0.80) and blood transfusion (OR 0.74, 95% CI 0.68-0.81) than delayed HA. Conclusion: Despite a slight increase, the rate of early arthroplasty remained at a low level in China. Given that early arthroplasty can significantly improve prognosis, more efforts are needed to optimize the procedure and shorten the time to surgery.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery