title: A national analysis of complications following hemiarthroplasty for hip fracture in older patients.
abstract: BACKGROUND
  There is emerging evidence that patients with fractured neck of femur (FNOF) aged >85 years have different demands on a health-care system when compared to younger patients.
  
  
  OBJECTIVE
  We sought to better quantify this in terms of comorbidity and complication rates.
  
  
  METHODS
  Retrospective review of national database.
  
  
  METHODS
  Data on all patients who underwent hip hemiarthroplasty for FNOF between January 2005 and December 2008 were extracted from the English hospital episode statistics database.
  
  
  RESULTS
  There were 41 770 patients aged 65-84 years and 35 321 patients aged ≥85 years. The older cohort was less likely to have diabetes, chronic obstructive pulmonary disease and rheumatoid arthritis. However, they exhibited a significantly higher risk of lower respiratory tract infection [odds ratio (OR) = 1.58, 95% confidence interval (CI) 1.50-1.67)], myocardial infarction (OR = 1.67, 1.52-1.83) and acute renal failure (OR = 1.54, 1.40-1.70) within 30 days of surgery with an inpatient mortality risk at 90 days, double that of the younger age group. Length of stay (LoS) was significantly longer in patients >85 years compared to younger patients (median 18 days vs. 15, P < 0.001).
  
  
  CONCLUSIONS
  Patients aged ≥85 years admitted for FNOF were found to have a lower incidence of major chronic disease but exhibited a greater incidence of acute events following hemiarthroplasty and their LoS was increased. Targeted medical interventions that focus upon this susceptible patient group may help reduce morbidity and improve survival.
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Northumberland, UK. simonjameson@doctors.org.uk
authors.forename: S S
authors.initials: SS
authors.lastname: Jameson
authors.forename: S K
authors.initials: SK
authors.lastname: Khan
authors.forename: P
authors.initials: P
authors.lastname: Baker
authors.forename: P
authors.initials: P
authors.lastname: James
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.forename: M R
authors.initials: MR
authors.lastname: Reed
authors.forename: D J
authors.initials: DJ
authors.lastname: Deehan
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology