Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2020; 11(10): 426-430
Published online Oct 18, 2020. doi: 10.5312/wjo.v11.i10.426
Mortality following combined fractures of the hip and proximal humerus
Aziz Haque, Harvinder Pal Singh
Aziz Haque, Harvinder Pal Singh, Department of Orthopaedic Surgery, University Hospitals of Leicester, Leicester B170RH, United Kingdom
Author contributions: Haque A was involved in the conception of the study along with data collection, analysis and write up of manuscript; Singh HP was involved in the conception, analysis and write up of the study.
Institutional review board statement: Ethics committee review was not required for this study.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aziz Haque, FRCS, Surgeon, Department of Orthopaedic Surgery, University Hospitals of Leicester, Gwendolen Road, Leicester B170RH, United Kingdom. aziz.leicester@gmail.com
Received: June 11, 2020
Peer-review started: June 11, 2020
First decision: July 21, 2020
Revised: August 3, 2020
Accepted: September 14, 2020
Article in press: September 14, 2020
Published online: October 18, 2020
Abstract
BACKGROUND

Hip fractures and proximal humerus fractures are known to be associated with increased mortality, but the impact on mortality of combining these two common injuries is not well known.

AIM

To compare mortality, inpatient stay and discharge destination for patients with combined hip and proximal humerus fractures with those sustaining isolated hip fractures.

METHODS

Using the United Kingdom national hip fracture database, we identified all hip fracture patients over the age of 60 admitted to a single trauma unit from 2010-2016. Patients sustaining a proximal humerus fracture in addition to their hip fracture were identified using hospital coding data. We calculated the 30-d and one-year mortality for both the hip fracture cohort and the combined hip and proximal humerus fracture cohort. Other variables recorded included age, gender and whether the proximal humerus was treated with or without an operation.

RESULTS

We identified 4131 patients with hip fractures within the study period and out of those 40 had sustained both a hip and a proximal humerus fracture. Mean age in the hip fracture cohort was 80.9 years and in the combined fracture group 80.3 years. Out of the 40 patients in the combined group four were treated operatively. The 30-d mortality for our hip fracture cohort was 7.2% compared to the mortality of our combined cohort of 12.5% (P = 0.163). The one-year mortality for our hip fracture cohort was 26.4% compared to 40% for the combined fracture cohort (P = 0.038). We also found patients with combined injuries were less likely to return to their own home.

CONCLUSION

The 30-d and one-year mortality is higher for those patients who have sustained a combined hip and proximal humerus fracture when compared to those with a hip fracture alone.

Keywords: Hip fracture, Proximal humerus fracture, Mortality, Return to home, Orthopaedics, Trauma

Core Tip: This simple paper highlights a higher mortality for those patients who have sustained a combined injury with a proximal humerus and hip fracture when compared to those with a hip fracture alone. This would be useful for the general orthopaedic surgeon when dealing and discussing risk of death with patients and their families.