Longer Operation Time in Hip Hemiarthroplasty Increases Mortality and Complication Rates: Study

A recent study highlighted the significant impact of various factors, specially the operation time on mortality and complication rates in patients undergoing hip hemiarthroplasty (HHA) for femoral neck fractures. This research spanned between January 2017 and December 2023 and screened a total of 552 eligible cases to uncover the key determinants that affect the patient outcomes post-surgery.

The study revealed that prolonged operation time is a crucial factor which influence the patient outcomes. For every additional minute of surgery, the odds of undergoing complications increased by 2.2%. Also, an operation time exceeding 86 minutes dramatically elevated the risk of mortality by 111.8% when compared to shorter procedures. These findings highlight the necessity of efficient surgical practices to minimize risks.

During the 90-day follow-up period, the study recorded a mortality rate of 9.1% and a complication rate of 6.2%. Among the complications notied, the infections were the most common which comprised 32.3% of cases. Other complications included dislocations (14.7%), trochanteric avulsions (20.7%), periprosthetic fractures (11.8%), nerve injuries (11.8%) and deep vein thrombosis (8.8%).

Apart from operation time, several other factors were found to significantly influence patient outcomes, which were;

• The odds of mortality increased by 8.8% for each additional year of age. This highlights the elevated vulnerability of older patients undergoing HHA.
• Surgeries performed by certified orthopedic surgeons showed a 61.5% reduction in mortality rates when compared to the procedures performed by trainees. This suggests the importance of surgical expertise and experience in enhancing patient survival rates.
  
• Male patients expressed a 168.7% higher risk of mortality when compared to female patients that indicated a gender disparity in outcomes that warrants further investigation.

The findings of this retrospective analysis illuminate the major importance of minimizing operation time during hip hemiarthroplasty to reduce the risk of complications and mortality. Also, the study highlights the need for experienced surgeons, especially for older and male patients who are at elevated risk. These insights can inform surgical best practices and enhance the patient care in orthopedic settings. Overall, the clear cut-off of 86 minutes for operation time serves as an important benchmark for surgical teams to effectively optimize procedures and ensure better patient prognoses.

Source:

Ramadanov, N., Salzmann, M., Voss, M., Hable, R., Hakam, H. T., Prill, R., Dimitrov, D., & Becker, R. (2024). The influence of operation time for hip hemiarthroplasty on complication rates and mortality in patients with femoral neck fracture: a retrospective data analysis. In Journal of Orthopaedic Surgery and Research (Vol. 19, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s13018-024-04797-7