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FACTORS AFFECTING IN-HOSPITAL MORTALITY AFTER FRACTURE NECK OF FEMUR. DO CEMENTED AND UNCEMENTED HEMIARTHROPLASTY DIFFER?



Abstract

In this study, we reviewed the records of 881 patients with fracture neck of femur over 5 years. Of these, 372 patients underwent hemiarthroplasty (231 cemented and 141 uncemented). The aim was to analyse the factors, which may contribute towards the mortality in cemented versus uncemented group.

The mean age in the cemented and uncemented group was 82 and 81 years respectively. 136 (58.8%) patients were operated within 24 hours of admission in the cemented group as compared to 63 (44.6%). The mean operative time was 81minutes for cemented hemiarthroplasty and 61 minutes for uncemented hemiarthroplasty. 77% of the cemented hemiarthroplasty was performed by Registrar grade as compared to 69% in the uncemented group. Of the 231 patients in the cemented group, 52% received general and 48% received spinal anaesthesia. Of the 141 patients in the uncemented group, 30% received general and 70% received spinal anaesthesia.

There was an 8% 30-day mortality compared to 11% 30-day mortality in uncemented group (p< 0.05). The mean age of patients in the mortality group was age 86 yrs in cement and 84 yrs in uncemented group. Most operations were done within 24–48 hours. There was significant co morbidity in patients who died. The average operative time of patients who died in both groups was same.

There was an increased mortality rate in the uncemented group as compared to the cemented group (p< 0.05). Based on our study, we conclude that cement is not a risk factor. Duration and timing of surgery is not associated with increased mortality. There was no difference in 30-day mortality rates between patients receiving general or spinal anaesthesia. Significant co morbid factor is associated with increased mortality.

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.