Risk Factors of Mortality in Patients With Periprosthetic Fractures: An Experience of 100 Cases.

objectiveThis study aims to determine the frequency and risk factors of mortality in patients with periprosthetic fractures. MATERIALS AND

methodsA retrospective review was conducted on 100 patients with periprosthetic fractures around hip and knee replacements. Inclusion criteria were radiological evidence of fracture and age >65 years. Exclusions included prior surgically treated fractures, fractures due to malignancy, lost follow-up, or unavailable postoperative data. Patients were analyzed for postoperative fracture union, complications, and mobility status using clinical and radiographic data. Data were analyzed using R software version 4.3.3 (R Foundation for Statistical Computing, Vienna, Austria), employing chi-square and Mann-Whitney U tests for categorical and numerical data, respectively, with logistic regression to control for confounders.

resultsThe mean time to operation was 3.25 ± 1.11 days. Among 100 patients, the mean age was 82.22 ± 6.90 years, with a slight male predominance n = 58 (58%). Hip fractures were more common (n = 73; 73%), with knee fractures comprising n = 27 (27%). Most patients were treated at district general hospitals (DGHs) (n = 86; 86%). Mortality within six months was n = 17 (17%). No significant gender differences in mortality were found (p = 0.3). Age >81 years was associated with higher mortality (p = 0.04). Nonoperative management was linked to higher mortality (p = 0.003). No significant differences were observed between hip and knee fracture mortality rates (p = 0.8) or across fracture complexity (p = 0.5). Multivariate analysis indicated higher mortality for nonoperated patients (OR: 0.18, p = 0.004).

conclusionAge and operative management significantly impacted mortality in periprosthetic fractures. Older age (≥81 years) and nonoperative management were linked to higher mortality rates.