Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty
Abstract Background Increasing life expectancy has led to a rise in hip fractures and an associated increase in hemiarthroplasty procedures aimed at restoring mobility and preventing muscle loss. Despite the extensive literature on failed hemiarthroplasty, limited data address the influence of pre-o...
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BMC
2025-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08364-x |
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| author | Kürşat Tuğrul Okur Koray Özdemir Ahmet Yesevi Sarıaslan Fırat Ozan |
| author_facet | Kürşat Tuğrul Okur Koray Özdemir Ahmet Yesevi Sarıaslan Fırat Ozan |
| author_sort | Kürşat Tuğrul Okur |
| collection | DOAJ |
| description | Abstract Background Increasing life expectancy has led to a rise in hip fractures and an associated increase in hemiarthroplasty procedures aimed at restoring mobility and preventing muscle loss. Despite the extensive literature on failed hemiarthroplasty, limited data address the influence of pre-operative fracture types—intracapsular versus extracapsular—on outcomes, including inpatient mortality. This study investigates the revisions of uncemented bipolar hemiarthroplasties concerning fracture type and identifies risk factors for inpatient mortality. Methods This retrospective cohort study included 68 patients (16 males and 52 females) who underwent revision of uncemented bipolar hemiarthroplasties at a single institution between 2017 and 2024. Data on demographics, comorbidities, fracture type, surgical details and outcomes were analysed. Statistical analyses included t tests, chi-square tests and logistic regression, with significance set at p < 0.05. Results Of 1,690 hemiarthroplasties performed, 68 required revision (revision rate: 4%). Revisions for extracapsular fractures were associated with a higher prevalence of diabetes mellitus (p = 0.01) and elevated Almelo Hip Fracture Score (AHFS; p = 0.01). The overall inpatient mortality rate was 19%, significantly higher in males (43.75%) than females (11.54%; p = 0.00). Deceased patients demonstrated higher AHFS and American Society of Anaesthesiologists scores but lower Parker Mobility Scores (p = 0.01). Prolonged intensive care unit (ICU) stays were also linked to increased mortality (p = 0.02). Logistic regression identified male sex as an independent predictor of mortality (odds ratio: 9.37; p < 0.05). Conclusions Pre-operative fracture type significantly influences revision outcomes in failed hemiarthroplasties. Moreover, extracapsular fractures are linked to diabetes mellitus and higher AHFS, whereas male sex, ICU stay duration and comorbidity scores predict inpatient mortality. These findings highlight the need for tailored perioperative care to mitigate risks. Trial registration Not applicable. |
| format | Article |
| id | doaj-art-c322313a9d44498e8f47976885f16eca |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-c322313a9d44498e8f47976885f16eca2025-02-09T12:04:18ZengBMCBMC Musculoskeletal Disorders1471-24742025-02-012611810.1186/s12891-025-08364-xIntracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplastyKürşat Tuğrul Okur0Koray Özdemir1Ahmet Yesevi Sarıaslan2Fırat Ozan3Department of Orthopaedics and Traumatology, Yozgat Sorgun State HospitalDepartment of Orthopaedics and Traumatology, University of Health Sciences Kayseri City Training and Research HospitalDepartment of Orthopaedics and Traumatology, University of Health Sciences Kayseri City Training and Research HospitalDepartment of Orthopaedics and Traumatology, University of Health Sciences Kayseri City Training and Research HospitalAbstract Background Increasing life expectancy has led to a rise in hip fractures and an associated increase in hemiarthroplasty procedures aimed at restoring mobility and preventing muscle loss. Despite the extensive literature on failed hemiarthroplasty, limited data address the influence of pre-operative fracture types—intracapsular versus extracapsular—on outcomes, including inpatient mortality. This study investigates the revisions of uncemented bipolar hemiarthroplasties concerning fracture type and identifies risk factors for inpatient mortality. Methods This retrospective cohort study included 68 patients (16 males and 52 females) who underwent revision of uncemented bipolar hemiarthroplasties at a single institution between 2017 and 2024. Data on demographics, comorbidities, fracture type, surgical details and outcomes were analysed. Statistical analyses included t tests, chi-square tests and logistic regression, with significance set at p < 0.05. Results Of 1,690 hemiarthroplasties performed, 68 required revision (revision rate: 4%). Revisions for extracapsular fractures were associated with a higher prevalence of diabetes mellitus (p = 0.01) and elevated Almelo Hip Fracture Score (AHFS; p = 0.01). The overall inpatient mortality rate was 19%, significantly higher in males (43.75%) than females (11.54%; p = 0.00). Deceased patients demonstrated higher AHFS and American Society of Anaesthesiologists scores but lower Parker Mobility Scores (p = 0.01). Prolonged intensive care unit (ICU) stays were also linked to increased mortality (p = 0.02). Logistic regression identified male sex as an independent predictor of mortality (odds ratio: 9.37; p < 0.05). Conclusions Pre-operative fracture type significantly influences revision outcomes in failed hemiarthroplasties. Moreover, extracapsular fractures are linked to diabetes mellitus and higher AHFS, whereas male sex, ICU stay duration and comorbidity scores predict inpatient mortality. These findings highlight the need for tailored perioperative care to mitigate risks. Trial registration Not applicable.https://doi.org/10.1186/s12891-025-08364-xAlmelo hip fracture scoreASA scoreDiabetes mellitusExtracapsular fractureHemiarthroplastyInpatient mortality |
| spellingShingle | Kürşat Tuğrul Okur Koray Özdemir Ahmet Yesevi Sarıaslan Fırat Ozan Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty BMC Musculoskeletal Disorders Almelo hip fracture score ASA score Diabetes mellitus Extracapsular fracture Hemiarthroplasty Inpatient mortality |
| title | Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| title_full | Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| title_fullStr | Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| title_full_unstemmed | Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| title_short | Intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| title_sort | intracapsular and extracapsular fracture types and inpatient mortality in failed hemiarthroplasty |
| topic | Almelo hip fracture score ASA score Diabetes mellitus Extracapsular fracture Hemiarthroplasty Inpatient mortality |
| url | https://doi.org/10.1186/s12891-025-08364-x |
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