Unlike Native Hip Fractures, Delay to Periprosthetic Hip Fracture Stabilization Does Not Significantly Affect Most Short-Term Perioperative Outcomes

Background: The incidence of periprosthetic hip fractures is increasing due to higher numbers of total hip arthroplasties being performed. Unlike native hip fractures, the effect of time to surgery of periprosthetic hip fractures is not well established. This study evaluates the effect of time to surgery on perioperative complications for patients with periprosthetic hip fractures. Methods: Patients who underwent surgery for periprosthetic hip fracture were identified in the 20052016 National Surgical Quality Improvement Program database and stratified into 2 groups: <2 and >= 2 days from hospital admission to surgery. Multivariate regressions were used to compare risk for perioperative complications between the 2 groups. Independent risk factors for postoperative serious adverse events were characterized. Results: In total, 409 (<2 days from admission to surgery) and 272 (>= 2 days from admission to surgery) patients were identified. Multivariate analysis revealed only higher risk of extended postoperative stay for patients who had delays of >= 2 days to surgery compared to those who had <2 days from admission to surgery. Independent risk factors for serious adverse events included increasing age, dependent preoperative functional status, and preoperative congestive heart failure, but not time to surgery. Conclusion: Unlike for native hip fractures, time to surgery for periprosthetic hip fractures does not appear to affect most 30-day perioperative complications. However, it is worth noting that this study was unable to control for all potential confounders and therefore the results may not be generalizable to all types of periprosthetic hip fractures. (C) 2018 Elsevier Inc. All rights reserved.