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· DOS Abstracts
Mortality in patients treated with cemented or
uncemented hemiarthroplasty - A study from the
Danish Multidisciplinary Registry of Hip Fractures
(DMRHF)
Bjarke Viberg, Alma Becic Pedersen, Anders Kjærsgaard, Søren Overgaard, Jens
Lauritsen
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital;
Department of Clinical Epidemiology, Aarhus University Hospital; Department of Clinical
Epidemiology, Aarhus University Hospital; Department of Orthopaedic Surgery and
Traumatology, Odense University Hospital; Department of Orthopaedic Surgery and
Traumatology, Odense University Hospital
Background:
Several nationwide studies have shown that cemented hemiarthroplasty
(cemHA) has higher mortality compared with uncemented (uncemHA) on the first post-
operative day and lower after 1 year but longer term results are not known.
Purpose / Aim of Study:
To compare the postoperative mortality after cemHA with
uncemHA in hip fracture patients with up to 5 years’ follow-up.
Materials and Methods:
This is a population based register study with data from
the DMRHF and the Danish National Registry of Patients. Data was retrieved from
01.01.2004 to 12.31.2013 with a minimum of 2 years’ follow-up on procedure codes
(NFB02, NFB12), age, sex, Charlson Comorbidity Index (CCI), reoperation status and
vital status. There were 70,652 hip fractures that included 45,809 osteosyntheses,
7,020 total hip arthroplasties and 17,283 HA.
Findings / Results:
There were 8751 uncemHA and 8532 cemHA, and the median age
(quartiles) was 84.2 (79.1-88.7) for uncemHA and 83.8 (78.5-88.5) for cemHA. There
were 76 % female in both groups and the median follow-up was 3.5 years. The mortality
for uncemHA compared to cemHA was within the first postoperative day 0.8 % versus
1.2 %, and reversed already after 1 week with 3.6 % versus 3.2 %. In a Cox-regression
analysis adjusted for age, sex, and CCI the Hazard Ration (HR) (95 % CI) for 1-day was
1.48 (1.10; 2.00), 1-week 0.94 (0.80; 1.10), 1 month 0.83 (0.73; 0.93), 1-year 0.87
(0.81; 0.94), and 5-years 0.98 (0.93; 1.03). The 1-day HR for cemHA patients with
CCI=0 is 3.43 (1.69;6.94), 0.90 (0.57;1.41) for CCI=1-2, and 1.70 (0.99;2.91) for
CCI≥3.
Conclusions:
Overall mortality was higher after one day, lower from one month to one
year and comparable at five years when comparing cemHA with uncemHA. An unexpect-
ed possibly U-shaped co-morbidity to mortality risk at 1-day associated with cemHA
warrants further study.
No conflicts of interest reported
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