Observational studyActa orthopaedica2020
Cognitive impairment influences the risk of reoperation after hip fracture surgery: results of 87,573 operations reported to the Norwegian Hip Fracture Register.
Observational study in Acta orthopaedica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 34 citations in OpenAlex.
- Full-Body Versus Local Wipe Disinfection With Chlorhexidine Gluconate: No Difference in Surgical Site Infection After Acute Hip Fracture Surgery.International wound journal · 2026Article
- Arthroplasty for femoral neck fracture of the elderly: a narrative review.EFORT open reviews · 2026Review
- No benefit in biomarkers assessing muscle damage for minimally invasive anterior over SPAIRE approach in hemiarthroplasty : a subgroup analysis with 100 patients from a randomized controlled trial.Bone & joint open · 2025Article
- An Acta Orthopaedica educational article: Femoral neck fractures in adults with emphasis on surgical treatment.Acta orthopaedica · 2025Review
- Disparities in the Diagnosis and Treatment of Osteoporosis in Persons with Cognitive Impairment and Dementia.Current osteoporosis reports · 2025Review
- SPAIRE approach shows equivalent changes in bone mineral density as a conventional approach in femoral neck fracture patients : a sub-group analysis of 49 patients from a randomized controlled trial.Bone & joint open · 2025Article
- Incidence of dislocation and associated risk factors in patients with a femoral neck fracture operated with an uncemented hemiarthroplasty.BMC musculoskeletal disorders · 2024Article
- Matters We Metric Vs. Metrics that Matter.Geriatric orthopaedic surgery & rehabilitation · 2024Review
- The impact of cognitive function on physical activity, physical function and quality of life in older adults following a hip fracture.Age and ageing · 2023Article
- Effect of Psychological Support Therapy on Psychological State, Pain, and Quality of Life of Elderly Patients With Femoral Neck Fracture.Frontiers in surgery · 2022Article
- Dislocation of hemiarthroplasty after hip fracture is common and the risk is increased with posterior approach: result from a national cohort of 25,678 individuals in the Swedish Hip Arthroplasty Register.Acta orthopaedica · 2021Article
- Patient-reported outcome measures after hip fracture in patients with chronic cognitive impairment : results from 34,675 patients in the Norwegian Hip Fracture Register.Bone & joint open · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - About one-fourth of hip fracture patients have cognitive impairment. We investigated whether patients' cognitive function affects surgical treatment, risk of reoperation, and mortality after hip fracture, based on data in the Norwegian Hip Fracture Register (NHFR).Patients and methods - This prospective cohort study included 87,573 hip fractures reported to the NHFR in 2005-2017. Hazard rate ratios (HRRs) for risk of reoperation and mortality were calculated using Cox regression adjusted for sex, age, ASA class, fracture type, and surgical method.Results - Cognitive impairment was reported in 27% of patients. They were older (86 vs. 82 years) and had higher ASA class than non-impaired patients. There were no differences in fracture type or operation methods. Cognitively impaired patients had a lower overall reoperation rate (4.7% vs. 8.9%, HRR 0.71; 95% CI 0.66-0.76) and lower risk of reoperation after osteosynthesis (HRR 0.58; CI 0.53-0.63) than non-impaired patients. Cognitively impaired hip fracture patients had an increased reoperation risk after hemiarthroplasty (HRR 1.2; CI 1.1-1.4), mainly due to dislocations (1.5% vs. 1.0%, HRR 1.7; CI 1.3-2.1). Risk of dislocation was particularly high following the posterior approach (4.7% vs. 2.8%, HRR 1.8; CI 1.2-2.7). Further, they had a higher risk of reoperation due to periprosthetic fracture after uncemented hemiarthroplasty (HRR 1.6; CI 1.0-2.6). Cognitively impaired hip fracture patients had higher 1-year mortality than those without cognitive impairment (38% vs. 16%, HRR 2.1; CI 2.1-2.2).Interpretation - Our findings support giving cognitively impaired patients the same surgical treatment as non-impaired patients. But since the risk of hemiprosthesis dislocation and periprosthetic fracture was higher in cognitively impaired patients, they should probably not have posterior approach surgery or uncemented implants.
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