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Joint Diseases and
Related Surgery
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Original Article · Open access

Predisposing factors for contralateral hip fractures in elderly patients over 80 years old

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Li-Ping Ma

Department of Emergency, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China

ORCID: 0000-0002-2030-3450

Bei-Chen Cui

Department of Emergency, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China

ORCID: 0009-0009-3853-0414

Jin-Qi Li

Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China

ORCID: 0009-0008-8844-2351

MM; Zhao-Xing Tian

Department of Emergency, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China

ORCID: 0009-0009-8920-9137

Abstract

Objectives: This study aims to identify risk factors associated with contralateral hip fractures in elderly patients over 80 years old following an initial hip fracture.

Patients and methods: Between May 2015 and April 2018, a total of 1,138 elderly patients (303 males, 805 females; median age: 85 years; interquartile range [IQR], 82 to 88 years) who were hospitalized for hip fractures were retrospectively analyzed. Data on demographics, comorbidities, and biochemical markers were collected during the initial hospitalization. Patients were followed for up to two years to identify cases of contralateral hip fractures. Risk factors were analyzed using univariate analyses and a Cox proportional hazards model using odds ratios (ORs) and confidence intervals (CIs).

Results: Of the patients, 98 (8.61%) experienced a contralateral hip fracture within two years. The incidence rates at 12 months and 24 months were 4.3% and 8.61%, respectively. Multivariable analysis identified chronic obstructive pulmonary disease (OR = 0.393, 95% CI 0.183-0.841), increasing Charlson Comorbidity Index (OR = 1.308, 95% CI 1.029-1.662), lower extremity deep vein thrombosis (OR = 0.168, 95% CI 0.079-0.354), pneumonia (OR = 0.133, 95% CI 0.075-0.236), and urinary tract infection (OR = 0.113, 95% CI 0.058-0.220) as significant risk factors for contralateral hip fractures.

Conclusion: Several key risk factors were found to be associated with contralateral hip fractures in elderly patients over 80 years old. Specifically, chronic obstructive pulmonary disease, increased Charlson Comorbidity Index, lower extremity deep vein thrombosis, pneumonia, and urinary tract infections significantly increased the risk of contralateral hip fractures. These findings highlight the importance of comprehensive assessment and targeted interventions in high-risk patients to mitigate the risk of subsequent fractures. Our results underscore the need for early identification of at-risk individuals and the implementation of preventive strategies to improve patient outcomes.

Declarations

Author Contributions

L.P.M., B.C.C., J.Q.L., Z.X.T.: Study design, data acquisition, data analysis and interpretation, manuscript preparation, manuscript review; Z.X.T.: Critical revision of the manuscript for intellectual content.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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