Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Feb 1;107-B(2):139-148.
doi: 10.1302/0301-620X.107B2.BJJ-2024-0251.R1.

Prevalence of complications in older adults after hip fracture surgery : a systematic review and meta-analysis

En Lin Goh  1 , Amulya Khatri  2 , Alexander B Costa  1 , Andrew Ting  3 , Kat Steiner  4 , May Ee Png  5 , David Metcalfe  1 , Jonathan A Cook  6 , Matthew L Costa  1
Affiliations
Meta-Analysis

Prevalence of complications in older adults after hip fracture surgery : a systematic review and meta-analysis

En Lin Goh et al. Bone Joint J. .

Abstract

Aims: Older adults with hip fractures are at high risk of experiencing complications after surgery, but estimates of the rate of specific complications vary by study design and follow-up period. The aim of this systematic review was to determine the prevalence of complications in older adults after hip fracture surgery.

Methods: MEDLINE, Embase, CINAHL, and CENTRAL databases were searched from inception until 30 June 2023. Studies were included if they reported prevalence data of complications in an unselected, consecutive population of older adults (aged ≥ 60 years) undergoing hip fracture surgery.

Results: A total of 95 studies representing 2,521,300 patients were included. For surgery-specific complications, the 30-day prevalence of reoperation was 2.31%, surgical site infection 1.69%, and deep surgical site infection 0.98%; the 365-day prevalence of prosthesis dislocation was 1.11%, fixation failure 1.77%, and periprosthetic or peri-implant fracture 2.23%. For general complications, the 30-day prevalence of acute kidney injury was 1.21%, blood transfusion 25.55%, cerebrovascular accident 0.79%, lower respiratory tract infection 4.08%, myocardial infarction 1.98%, urinary tract infection 7.01%, and venous thromboembolism 2.15%.

Conclusion: Complications are prevalent in older adults who have had surgery for a hip fracture. Studies reporting complications after hip fracture surgery varied widely in terms of quality, and we advocate for the routine monitoring of complications in registries and clinical trials to improve the quality of evidence.

PubMed Disclaimer

Conflict of interest statement

E. L. Goh reports an institutional research grant from National Institute for Health and Care Research (NIHR) which enabled research for this study. M. L. Costa's employer, the University of Oxford, receives research grant funding from NIHR and Wellcome for research into musculoskeletal trauma. D. Metcalfe reports an institutional research grant from NIHR and an institutional programme grant from the Kadoorie Charitable Foundation, neither of which are related to this study.

References

    1. Goh EL , Lerner RG , Achten J , Parsons N , Griffin XL , Costa PML . Complications following hip fracture: results from the World Hip Trauma Evaluation cohort study . Injury . 2020 ; 51 ( 6 ): 1331 – 1336 . 10.1016/j.injury.2020.03.031 32268962
    1. Prieto-Alhambra D , Reyes C , Sainz MS , et al. In-hospital care, complications, and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study . Arch Osteoporos . 2018 ; 13 ( 1 ): 96 . 10.1007/s11657-018-0515-8 30218380
    1. Hansson S , Rolfson O , Åkesson K , Nemes S , Leonardsson O , Rogmark C . Complications and patient-reported outcome after hip fracture. A consecutive annual cohort study of 664 patients . Injury . 2015 ; 46 ( 11 ): 2206 – 2211 . 10.1016/j.injury.2015.07.024 26298023
    1. Roche JJW , Wenn RT , Sahota O , Moran CG . Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study . BMJ . 2005 ; 331 ( 7529 ): 1374 . 10.1136/bmj.38643.663843.55 16299013
    1. Inacio MCS , Weiss JM , Miric A , Hunt JJ , Zohman GL , Paxton EW . A community-based hip fracture registry: population, methods, and outcomes . Perm J . 2015 ; 19 ( 3 ): 29 – 36 . 10.7812/TPP/14-231 26057682