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Multicenter Study
. 2025 Mar 1;107-B(3):362-367.
doi: 10.1302/0301-620X.107B3.BJJ-2024-0858.R1.

The risk of complications after hip fracture

En Lin Goh  1 , May Ee Png  2 , David Metcalfe  1 , Juul Achten  1 , Duncan Appelbe  1 , Xavier L Griffin  3 , Jonathan A Cook  4 , Matthew L Costa  1 ; WHiTE Investigators
Collaborators, Affiliations
Multicenter Study

The risk of complications after hip fracture

En Lin Goh et al. Bone Joint J. .

Abstract

Aims: The risk of mortality after a hip fracture has been extensively investigated, but there is little high-quality information available dealing with the overall risk of complications. The aim of this study was to report the risk of complications in the first 120 days after a hip fracture.

Methods: This was a multicentre, prospective cohort study of patients aged > 60 years with a hip fracture, involving 77 hospitals in England, Wales, and Northern Ireland, between January 2015 and 2022. The primary outcomes of interest were mortality and surgery-specific and general complications, at 120 days postoperatively.

Results: A total of 24,523 patients with a hip fracture were enrolled. The 120-day risk of mortality was 12.4% (95% CI 12.0 to 12.8). The 120-day risks of surgery-specific complications were: for dislocation, 1.5% (95% CI 1.3 to 1.7); failure of fixation, 1.0% (95% CI 0.8 to 1.2); for peri-implant or periprosthetic fracture, 0.3% (95% CI 0.3 to 0.4); for reoperation for any indication, 2.7% (95% CI 2.5 to 2.9); and for surgical site infection, 3.4% (95% CI 3.2 to 3.6). The 120-day risks of general complications were: for acute kidney injury, 3.4% (95% CI 3.1 to 3.6); for the requirement of a blood transfusion, 7.0% (95% CI 6.7 to 7.3); for lower respiratory tract infection, 9.1% (95% CI 8.7 to 9.4); for urinary tract infection, 7.0% (95% CI 6.7 to 7.3); for cerebrovascular accident, 0.7% (95% CI 0.6 to 0.8); for myocardial infarction, 0.7% (95% CI 0.6 to 0.9); and for venous thromboembolism, 1.8% (95% CI 1.6 to 2.0).

Conclusions: Although the risk of mortality has declined in recent years, older patients with a hip fracture remain at a high risk of surgery-specific and general complications.

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Conflict of interest statement

E. L. Goh reports an institutional research grant from National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, which enabled research for this study. J. Achten reports NIHR funding, related to this study, as well as grants or contracts from NIHR, unrelated to this study. D. Applebe reports NIHR/Health Technology Assessment (HTA) institutional funding, related to this study. X. L. Griffin reports NIHR Research for Patient Benefit (RfPB) funding, related to this study, as well as multiple grants from UK Research and Innovation (UKRI) and charity, unrelated to this study. J. Cook reports NIHR funding, related to this study. M. L. Costa reports funding from NIHR and the Wellcome Trust, unrelated to this study.

References

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