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Does cementing the femoral component increase the risk of peri-operative mortality for patients having replacement surgery for a fracture of the neck of femur? : data from the National Hip Fracture Database

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Costa, Matthew L., Griffin, Xavier L., Pendleton, N., Pearson, Mike, FRCP and Parsons, Nicholas R. (2011) Does cementing the femoral component increase the risk of peri-operative mortality for patients having replacement surgery for a fracture of the neck of femur? : data from the National Hip Fracture Database. Journal of Bone and Joint Surgery - British Volume, Vol.93-B (No.10). pp. 1405-1410. doi:10.1302/0301-620X.93B10.26690 ISSN 0301-620X.

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Official URL: http://dx.doi.org/10.1302/0301-620X.93B10.26690

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Abstract

Concerns have been reported to the United Kingdom National Patient Safety Agency, warning that cementing the femoral component during hip replacement surgery for fracture of the proximal femur may increase peri-operative mortality. The National Hip Fracture Database collects demographic and outcome data about patients with a fracture of the proximal femur from over 100 participating hospitals in the United Kingdom. We conducted a mixed effects logistic regression analysis of this dataset to determine whether peri-operative mortality was increased in patients who had undergone either hemiarthroplasty or total hip replacement using a cemented femoral component. A total of 16 496 patients from 129 hospitals were included in the analysis, which showed a small but significant adjusted survival benefit associated with cementing (odds ratio 0.83, 95% confidence interval 0.72 to 0.96). Other statistically significant variables in predicting death at discharge, listed in order of magnitude of effect, were gender, American Society of Anesthesiologists grade, age, walking accompanied outdoors and arthroplasty. Interaction terms between cementing and these other variables were sequentially added to, but did not improve, the model. This study has not shown an increase in peri-operative mortality as a result of cementing the femoral component in patients requiring hip replacement following fracture of the
proximal femur.

Item Type: Journal Article
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Library of Congress Subject Headings (LCSH): Arthroplasty, Operations, Surgical, Femur -- Surgery, Femur neck
Journal or Publication Title: Journal of Bone and Joint Surgery - British Volume
Publisher: British Editorial Society of Bone and Joint Surgery
ISSN: 0301-620X
Official Date: October 2011
Dates:
DateEvent
October 2011Published
Volume: Vol.93-B
Number: No.10
Page Range: pp. 1405-1410
DOI: 10.1302/0301-620X.93B10.26690
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

Data sourced from Thomson Reuters' Web of Knowledge

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