Risk Factors for Recurrent Hip Fractures Following Surgical Treatment of Primary Osteoporotic Hip Fractures in Chinese Older Adults

TL;DR

This study identifies risk factors for hip fractures recurring after initial treatment in older Chinese adults and suggests ways to reduce recurrence.

Contribution

The study identifies specific risk and protective factors for recurrent hip fractures in older adults following osteoporotic fracture surgery.

Findings

Age ≥ 85 years, COPD, and Parkinson’s disease are independent risk factors for recurrent hip fractures.

Antiosteoporosis drugs and longer treatment duration are protective against recurrence.

Patients with recurrent fractures had a higher three-year mortality rate.

Abstract

Objectives: Hip fractures associated with osteoporosis are indicative of high rates of both disability and mortality. The objective of this study was to analyze the risk factors for recurrent hip fractures following primary osteoporotic hip fracture surgery in older adult patients. Methods: A single-center, retrospective cohort study was conducted on 376 patients suffering from primary osteoporotic hip fractures from 1 January 2020 to 31 December 2021. Multivariate logistic regression was used to identify risk factors for recurrent hip fractures. Results: The study observed 376 patients over a period of three years. The incidence of recurrent hip fractures was 20.5% (77/376). Multiple logistic regression analysis revealed that age ≥ 85 years (odd ratios [OR] = 3.127, 95% confidence interval [CI] = 1.672–5.849, p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 3.794, 95%CI = 1.747–8.236, p < 0.001), and Parkinson’s disease (PD) (OR = 2.744, 95%CI = 1.249–6.028, p = 0.012) were independent risk factors for recurrent hip fractures; antiosteoporosis drugs (OR = 0.243, 95%CI = 0.131–0.451, p < 0.001), duration of antiosteoporosis drug therapy (OR = 0.564, 95%CI = 0.283–0.830, p = 0.003) and serum albumin ≥ 35 g·L−1 (OR = 0.413, 95%CI = 0.194–0.881, p = 0.022) were independent protective factors for recurrent hip fractures. The receiver operating characteristic (ROC) curve demonstrated that the AUC was 0.802, the sensitivity was 77.8%, and the specificity was 75.5%. A significantly higher three-year mortality rate was observed among patients with recurrent hip fractures (26.0% vs. 15.4%, p = 0.029). Conclusions: Older patients with advanced age, COPD and PD were at greater risk of recurrent hip fractures. Early nutrition intervention and antiosteoporosis drug therapy may decrease the incidence of recurrent hip fractures in older patients, thereby reducing mortality.

Figures