The Effects of Cement Fixation on Survival in Elderly Patients with Hip Hemiarthroplasty: a Nationwide Cohort Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2019 Dec 29

PMID 31881878

Citations 7

Authors

Ming-Che Tsai

Yee-Yung Ng

Wei-Ming Chen

Shang-Wen Tsai

Shiao-Chi Wu

Affiliations

Soon will be listed here.

Abstract

Background: Hip hemiarthroplasty (HHA) is a common treatment for hip fractures in the elderly population. Because of the fatal effects of bone cement implantation syndrome, the safety of cement utilization to enhance implant firmness in the femur is controversial. The aim of this study was to investigate the postoperative survival of elderly patients receiving HHA with and without cement fixation.

Methods: Claim data from the National Health Insurance Database and the National Register of Deaths Database were used for analysis in this retrospective cohort study. From 2008 to 2014, 25,862 patients aged 80 years or older treated with hip hemiarthroplasty were included in the analysis. A Cox proportional risk model was used to analyse the effects of cement utilization on postoperative mortality.

Results: The cemented group had a significantly higher mortality risk than the non-cemented group within 7, 30, 180 days and 1 year after the operation. The effect of bone cement on postoperative mortality was significantly stronger within 7 days than within 30, 180 days and 1 year. In addition, the male gender, age > 85 years and higher score on the Charlson Comorbidity Index were also risk factors for mortality (p < 0.05). Patients who received HHA in lower-volume hospitals had higher mortality rates within 180 days and 1 year than those in higher-volume hospitals. Compared with patients who were operated on by high-volume surgeons, those who received surgery performed by lower-volume surgeons were more likely to die within 30 days (aHR = 1.22), 180 days (aHR = 1.16) and 1 year (aHR = 1.19), respectively.

Conclusions: The postoperative mortality rate of elderly patients undergoing HHA was significantly higher in the cemented group than in the non-cemented group.

Citing Articles

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Magnusson J, Karlsson J, Skoldenberg O, Albert J, Frostell C, Jakobsson J J Orthop Surg Res. 2024; 19(1):295.

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The impact of cement fixation on early mortality in arthroplasty for hip fracture.

Ramsay N, Close J, Harris I, Harvey L Bone Jt Open. 2023; 4(3):198-204.

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Outcomes of fixation of Vancouver B periprosthetic fractures around cemented versus uncemented stems.

Barghi A, Hanna P, Merchan N, Weaver M, Wixted J, Appleton P BMC Musculoskelet Disord. 2023; 24(1):263.

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Recent advances in geriatric anaesthesia.

Mahender A, Chavan S, Saroa R, Chauhan M Indian J Anaesth. 2023; 67(1):152-158.

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