title: Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone: results from a United Kingdom teaching hospital.
abstract: BACKGROUND
  A proportion of patients sustaining hip fractures present with a concomitant fracture. We aimed to evaluate the relationship between patient characteristics and clinical outcomes, in those with a hip and concomitant fracture compared with those sustaining a hip fracture alone from a clinical service registry.
  
  
  METHODS
  Cross-sectional study using data obtained from a clinical service registry (Nottingham Hip Fracture Database) on patients aged 50 and above who suffered a hip fracture between 1/1/2003 and 31/12/2012. Data was collected on patient demographics, fracture information and healthcare outcomes.
  
  
  RESULTS
  7338 patients of which 75 % were female (mean age 82 (SD 9.4), had a hip fracture with 334 (4.6 %) patients having a concomitant fracture. The majority (58 %) were distal radius or proximal humeral fractures. Only females (p = 0.002), those taking three or fewer medications (p = 0.018) and those on long term steroids (p = 0.048) were more likely to suffer a concomitant fracture. There was no difference in mortality, rates of postoperative complication, intensive care unit or care home admission between both groups. Patients with a concomitant fracture have a 16 % longer average length of stay in hospital (mean difference 1.16; 95 % CI 1.07-1.25, p < 0.001).
  
  
  CONCLUSIONS
  Patients with concomitant fractures have similar patient characteristics, except gender, polypharmacy and long term steroid use; and outcomes to those presenting with hip fracture alone, except a longer average inpatient stay.
authors.affiliation: Department of Healthcare for Older People, Queens Medical Centre, Nottingham, NG7 2UH, UK. terenceong@doctors.org.uk.
authors.forename: Terence
authors.initials: T
authors.lastname: Ong
authors.affiliation: Department of Healthcare for Older People, Queens Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Varun
authors.initials: V
authors.lastname: Anand
authors.affiliation: Nottingham Clinical Trials Unit, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
authors.forename: Wei
authors.initials: W
authors.lastname: Tan
authors.affiliation: Department of Healthcare for Older People, Queens Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Edmund
authors.initials: E
authors.lastname: Quah
authors.affiliation: Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Moran
authors.affiliation: Department of Healthcare for Older People, Queens Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Opinder
authors.initials: O
authors.lastname: Sahota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications; D011885:Radius Fractures / Q000175:diagnosis / Q000601:surgery; D012784:Shoulder Fractures / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Bone fragility; Concomitant fracture; Fall; Fragility fractures; Hip fractures; Osteoporosis; Osteoporotic fractures