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Unplanned emergency department visits within 90 days of hip hemiarthroplasty for osteoporotic femoral neck fractures: Reasons, risks, and mortalities.
Wang, Yang-Yi; Chou, Yi-Chuan; Tsai, Yuan-Hsin; Chang, Chih-Wei; Chen, Yi-Chen; Tai, Ta-Wei.
Afiliación
  • Wang YY; Department of Orthopedic Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
  • Chou YC; Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Tsai YH; Department of Biomedical Engineering, National Cheng Kung University, Tainan, 701, Taiwan.
  • Chang CW; Department of Orthopedic Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
  • Chen YC; Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, 402, Taiwan.
  • Tai TW; Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Osteoporos Sarcopenia ; 10(2): 66-71, 2024 Jun.
Article en En | MEDLINE | ID: mdl-39035225
ABSTRACT

Objectives:

Bipolar hemiarthroplasty is commonly performed to treat displaced femoral neck fractures in osteoporotic patients. This study aimed to assess the occurrence and outcomes of unplanned return visits to the emergency department (ED) within 90 days following bipolar hemiarthroplasty for displaced femoral neck fractures.

Methods:

The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients' electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed.

Results:

Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient's returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P < 0.001) and a greater overall mortality rate (26.2% vs 10.5%, P < 0.001).

Conclusions:

This study highlights the importance of identifying risk factors for unplanned ED visits after bipolar hemiarthroplasty, which may contribute to a better prognosis. Consideration should be given to the use of cemented implants for hemiarthroplasty, as uncemented implants are associated with a greater risk of periprosthetic fractures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Osteoporos Sarcopenia Año: 2024 Tipo del documento: Article País de afiliación: Taiwán

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Osteoporos Sarcopenia Año: 2024 Tipo del documento: Article País de afiliación: Taiwán