title: Risk factors for contra-lateral hip fracture in elderly patients with previous hip fracture.
abstract: BACKGROUND
  Contra-lateral hip fractures in elderly patients with a previous hip fracture increase the incidence of complications and socioeconomic burden. The purpose of this study was to identify the risk factors that contribute to the occurrence of contra-lateral hip fracture in elderly patients.
  
  
  METHODS
  Among 1093 patients treated for a hip fracture, 47 patients sustained a contra-lateral hip fracture. These patients were compared with 141 patients with a unilateral hip fracture (controls).
  
  
  RESULTS
  The incidence of contra-lateral hip fracture was 4.3% among the 1093 patients treated for a hip fracture at our institute. A contra-lateral hip fracture occurred within 2 years of initial fracture in 66%, and subsequently, the annual incidence rate decreased. A similar fracture pattern was noted in 70% of patients who sustained an intertrochanteric fracture. In terms of preoperative factors, respiratory disease (OR 2.57, P=0.032) and visual impairment (OR 2.51, P=0.012) were higher in patients with a contra-lateral hip fracture than in controls, and for postoperative factors, the proportions of patients with postoperative delirium (OR 2.91, P=0.022), late onset of rehabilitation (OR 1.05, P=0.023), and poor ambulatory status at 3 months (OR 1.34, P=0.002) were also significantly higher in patients than in controls.
  
  
  CONCLUSIONS
  Postoperative delirium and underlying visual impairment and respiratory disease could be risk factors of contra-lateral fracture in elderly patients. Early and active rehabilitation after surgery is important to prevent the occurrence of contra-lateral hip fracture in the elderly.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Hallym University, Republic of Korea.
authors.forename: Jun-Dong
authors.initials: JD
authors.lastname: Chang
authors.forename: Je-Hyun
authors.initials: JH
authors.lastname: Yoo
authors.forename: Pradeep
authors.initials: P
authors.lastname: Reddy
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Ji-Hyo
authors.initials: JH
authors.lastname: Hwang
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000150:complications* / Q000209:etiology; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000401:mortality / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000150:complications*; D056910:Republic of Korea / Q000453:epidemiology; D012131:Respiratory Insufficiency / Q000150:complications*; D012307:Risk Factors; D013997:Time Factors; D014786:Vision Disorders / Q000150:complications*
keywords: Contra-lateral fracture; Elderly; Hip; Risk factor