Mortality Rate in Periprosthetic Proximal Femoral Fractures: Impact of Time to Surgery

Abstract

Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to examine the correlation between surgery timing and mortality in PPFF patients. In a historical cohort study, we analyzed data from 79 PPFF patients treated from 2012 to 2022. Patients were categorized by surgery timing (≤48 h, 32 patients vs. >48 h, 47 patients). Outcomes and mortality rates were compared. No significant difference in mortality was observed between patients undergoing early (48 h) surgery at 30 days and 1 year. Factors such as age (p = 0.154), gender (p = 0.058), ASA score (p = 0.893), Vancouver classification (p = 0.577), and surgery type (implant revision p = 0.691, OR = 0.667) did not affect 30-day mortality. However, 1-year mortality was influenced by gender (male p = 0.045) and age (p = 0.004), but not by other variables (Vancouver classification p = 0.443, implant revision p = 0.196). These findings indicate no association between surgery timing and mortality in PPFF patients, suggesting that other factors may influence outcomes. Further research is needed to optimize PPFF management.

Keywords

• early surgery
• periprosthetic
• fracture
• proximal femur