Evidence map›Paper›PMID 38658870›Full record

ArticleBMC musculoskeletal disorders2024

Comparison of acute outcomes from elective total hip replacements and after fragility femoral neck fractures in nonagenarians.

Zahra Al-Essah, Keegan Curlewis, Gareth Chan, Karim Tokeisham, Koushik Ghosh, Philip Stott, Benedict A Rogers

Open access · goldAbstract readComparative Study
In one paragraph

Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Zahra Al-EssahBrighton and Sussex Medical School, Brighton, UK.
Keegan CurlewisRoyal Free NHS Foundation Trust, London, UK.
Gareth ChanBrighton and Sussex Medical School, Brighton, UK. gareth.chan@nhs.net.
Karim TokeishamUniversity Hospitals NHS Foundation Trust, Sussex, UK.
Koushik GhoshUniversity Hospitals NHS Foundation Trust, Sussex, UK.
Philip StottUniversity Hospitals NHS Foundation Trust, Sussex, UK.
Benedict A RogersBrighton and Sussex Medical School, Brighton, UK.
Brighton and Sussex Medical School · GBUniversity Hospitals Sussex NHS Foundation Trust · GBRoyal Free London NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHip hemiarthroplasty has traditionally been used to treat displaced femoral neck fractures in older, frailer patients whilst total hip replacements (THR) have been reserved for younger and fitter patients. However, not all elderly patients are frail, and some may be able to tolerate and benefit from an acute THR. Nonagenarians are a particularly heterogenous subpopulation of the elderly, with varying degrees of independence. Since THRs are performed electively as a routine treatment for osteoarthritis in the elderly, its safety is well established in the older patient. The aim of this study was to compare the safety of emergency THR to elective THR in nonagenarians.

methodsA retrospective 10-year cohort study was conducted using data submitted to the National Hip Fracture Database (NHFD) across three hospitals in one large NHS Trust. Data was collected from 126 nonagenarians who underwent THRs between 1st January 2010 - 31st December 2020 and was categorised into emergency THR and elective THR groups. Mortality rates were compared between the two groups. Secondary outcomes were also compared including postoperative complications (dislocations, revision surgeries, and periprosthetic fracture), length of stay in hospital, and discharge destination.

resultsThere was no significant difference in mortality between the two groups, with 1-year mortality rates of 11.4% and 12.1% reported for emergency and elective patients respectively (p = 0.848). There were no significant differences in postoperative complication rate and discharge destination. Patients who had emergency THR spent 5.56 days longer in hospital compared to elective patients (p = 0.015).

conclusionThere is no increased risk of 1-year mortality in emergency THR compared to elective THR, in a nonagenarian population. Therefore, nonagenarians presenting with a hip fracture who would have been considered for a THR if presenting on an elective basis should not be precluded from an emergency THR on safety grounds.

trial registrationNot necessary as this was deemed not to be clinical research, and was considered to be a service evaluation.

Indexed as

Arthroplasty, Replacement, HipElective Surgical ProceduresFemoral Neck FracturesPostoperative ComplicationsAged, 80 and overFemaleHumansLength of StayMaleReoperationRetrospective StudiesTreatment OutcomeFemoral neck fractureNeck of femurNonagenariansTotal hip replacement

Identifiers

PMID38658870
PMCPMC11040911
OpenAlexW4395117104

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.