Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database
Takahisa Ogawa,1 Toshitaka Yoshii,1 Atsushi Okawa,1 Kiyohide Fushimi,2 Tetsuya Jinno1,3 1Department of Orthopaedic and Spine Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; 2Department of Health Policy and Informatics, Tokyo Medical and Dental University Gradu...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2021-06-01
|
Series: | Clinical Interventions in Aging |
Subjects: | |
Online Access: | https://www.dovepress.com/association-between-cemented-vs-cementless-hemiarthroplasty-and-short--peer-reviewed-fulltext-article-CIA |
id |
doaj-4d6a791113f44450b6b7c6482d098403 |
---|---|
record_format |
Article |
spelling |
doaj-4d6a791113f44450b6b7c6482d0984032021-06-24T22:41:49ZengDove Medical PressClinical Interventions in Aging1178-19982021-06-01Volume 161151115966065Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter DatabaseOgawa TYoshii TOkawa AFushimi KJinno TTakahisa Ogawa,1 Toshitaka Yoshii,1 Atsushi Okawa,1 Kiyohide Fushimi,2 Tetsuya Jinno1,3 1Department of Orthopaedic and Spine Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; 2Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; 3Department of Orthopaedic Surgery, Dokkyo Medical University, Saitama Medical Center, Saitama, JapanCorrespondence: Tetsuya JinnoDepartment of Orthopaedic Surgery, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, JapanTel +81-48-965-1111Email jinnot@dokkyomed.ac.jpTakahisa OgawaDepartment of Orthopaedic and Spine Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, JapanTel +81-3-3813-6111Email takahisa.o@gmail.comObjective: Cemented hemiarthroplasty is recommended for the vulnerable hip fracture population because of beneficial long-term outcomes. However, the association between cemented hemiarthroplasty and short-term mortality is controversial. To increase a preparedness of potential complication after cemented hemiarthroplasty, we aimed to evaluate the trajectory of the effect of cemented hemiarthroplasty on short-term in-hospital outcomes.Methods: We investigated in-hospital mortality and complications between cemented hemiarthroplasty and cementless hemiarthroplasty using a nationwide multicenter database from 2010 to 2016 with a propensity-score matching analysis. We analyzed in-hospital mortality from 1 to 14 days after surgery. We also investigated in-hospital complications that may associate with mortality.Results: After matching of 31,322 cases, we found no significant difference in 30-day in-hospital mortality between the cemented and cementless hemiarthroplasty groups (hazard ratio, HR [95% confidence interval, CI], 1.2 [0.89– 1.6], p = 0.23). However, the 1- to 10-day postoperative mortality rates were significantly higher in the cemented group and the association becomes weaker as the postoperative period increased (day 1; HR [95% CI]: 3.5 [1.6– 7.68]; day 10; HR [95% CI]: 1.59 [1.07– 2.37]). The incidence of stroke and intensive care unit (ICU) admission was also significantly higher in the cemented group.Conclusion: Cemented hemiarthroplasty was not significantly associated with an increase in overall in-hospital mortality but was significantly associated with short-term mortality from 1-day to 10-day after surgery. The incidence of stroke and ICU admission was also significantly higher in the cemented group. Surgeons should pay more attention to the risk of mortality and stroke in patients undergoing cemented hemiarthroplasty, especially in the early days of hospitalization.Keywords: national database, complication, geriatric fracture, stroke, intensive care unit admission, ICU admissionhttps://www.dovepress.com/association-between-cemented-vs-cementless-hemiarthroplasty-and-short--peer-reviewed-fulltext-article-CIAnational databasecomplicationgeriatric fracturestrokeintensive care unit (icu) admission |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ogawa T Yoshii T Okawa A Fushimi K Jinno T |
spellingShingle |
Ogawa T Yoshii T Okawa A Fushimi K Jinno T Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database Clinical Interventions in Aging national database complication geriatric fracture stroke intensive care unit (icu) admission |
author_facet |
Ogawa T Yoshii T Okawa A Fushimi K Jinno T |
author_sort |
Ogawa T |
title |
Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database |
title_short |
Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database |
title_full |
Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database |
title_fullStr |
Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database |
title_full_unstemmed |
Association Between Cemented vs Cementless Hemiarthroplasty and Short-Term Change of In-Hospital Mortality in Elderly Patients with Femoral Neck Fracture: A Propensity-Score Matching Analysis in a Multicenter Database |
title_sort |
association between cemented vs cementless hemiarthroplasty and short-term change of in-hospital mortality in elderly patients with femoral neck fracture: a propensity-score matching analysis in a multicenter database |
publisher |
Dove Medical Press |
series |
Clinical Interventions in Aging |
issn |
1178-1998 |
publishDate |
2021-06-01 |
description |
Takahisa Ogawa,1 Toshitaka Yoshii,1 Atsushi Okawa,1 Kiyohide Fushimi,2 Tetsuya Jinno1,3 1Department of Orthopaedic and Spine Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; 2Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; 3Department of Orthopaedic Surgery, Dokkyo Medical University, Saitama Medical Center, Saitama, JapanCorrespondence: Tetsuya JinnoDepartment of Orthopaedic Surgery, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, JapanTel +81-48-965-1111Email jinnot@dokkyomed.ac.jpTakahisa OgawaDepartment of Orthopaedic and Spine Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, JapanTel +81-3-3813-6111Email takahisa.o@gmail.comObjective: Cemented hemiarthroplasty is recommended for the vulnerable hip fracture population because of beneficial long-term outcomes. However, the association between cemented hemiarthroplasty and short-term mortality is controversial. To increase a preparedness of potential complication after cemented hemiarthroplasty, we aimed to evaluate the trajectory of the effect of cemented hemiarthroplasty on short-term in-hospital outcomes.Methods: We investigated in-hospital mortality and complications between cemented hemiarthroplasty and cementless hemiarthroplasty using a nationwide multicenter database from 2010 to 2016 with a propensity-score matching analysis. We analyzed in-hospital mortality from 1 to 14 days after surgery. We also investigated in-hospital complications that may associate with mortality.Results: After matching of 31,322 cases, we found no significant difference in 30-day in-hospital mortality between the cemented and cementless hemiarthroplasty groups (hazard ratio, HR [95% confidence interval, CI], 1.2 [0.89– 1.6], p = 0.23). However, the 1- to 10-day postoperative mortality rates were significantly higher in the cemented group and the association becomes weaker as the postoperative period increased (day 1; HR [95% CI]: 3.5 [1.6– 7.68]; day 10; HR [95% CI]: 1.59 [1.07– 2.37]). The incidence of stroke and intensive care unit (ICU) admission was also significantly higher in the cemented group.Conclusion: Cemented hemiarthroplasty was not significantly associated with an increase in overall in-hospital mortality but was significantly associated with short-term mortality from 1-day to 10-day after surgery. The incidence of stroke and ICU admission was also significantly higher in the cemented group. Surgeons should pay more attention to the risk of mortality and stroke in patients undergoing cemented hemiarthroplasty, especially in the early days of hospitalization.Keywords: national database, complication, geriatric fracture, stroke, intensive care unit admission, ICU admission |
topic |
national database complication geriatric fracture stroke intensive care unit (icu) admission |
url |
https://www.dovepress.com/association-between-cemented-vs-cementless-hemiarthroplasty-and-short--peer-reviewed-fulltext-article-CIA |
work_keys_str_mv |
AT ogawat associationbetweencementedvscementlesshemiarthroplastyandshorttermchangeofinhospitalmortalityinelderlypatientswithfemoralneckfractureapropensityscorematchinganalysisinamulticenterdatabase AT yoshiit associationbetweencementedvscementlesshemiarthroplastyandshorttermchangeofinhospitalmortalityinelderlypatientswithfemoralneckfractureapropensityscorematchinganalysisinamulticenterdatabase AT okawaa associationbetweencementedvscementlesshemiarthroplastyandshorttermchangeofinhospitalmortalityinelderlypatientswithfemoralneckfractureapropensityscorematchinganalysisinamulticenterdatabase AT fushimik associationbetweencementedvscementlesshemiarthroplastyandshorttermchangeofinhospitalmortalityinelderlypatientswithfemoralneckfractureapropensityscorematchinganalysisinamulticenterdatabase AT jinnot associationbetweencementedvscementlesshemiarthroplastyandshorttermchangeofinhospitalmortalityinelderlypatientswithfemoralneckfractureapropensityscorematchinganalysisinamulticenterdatabase |
_version_ |
1721360957765058560 |