Greater length of hospital stay for concurrent hip and upper limb fractures compared to isolated hip fractures: a systematic review of 13 studies including 210,289 patients and meta-analysis

Sharrock, Martin; Hagan, J. T.; Lee, Joshua; Charalambous, Charalambos Panayiotou

doi:10.1016/j.injury.2022.05.039

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…All studies agree on the fact that concomitant fractures lead to longer hospitalization [18,23,30,31]. Di Monaco [22] further evaluated the types of fractures and found a prolonged length of stay for patients with a proximal humerus fracture but not for fractures concerning the distal forearm whilst Kim et al [8] did not differentiate between the types of upper limb fractures and saw an increase in length of hospital stay for mean 1.67 days which is very similar to the results of our cohort showing an increase of the average 1.96 days.…”

Section: Discussionmentioning

confidence: 59%

Concomitant fractures in patients with proximal femoral fractures lead to a prolonged hospital stay but not to increased complication rates or in-house mortality if treated surgically: a matched pair analysis

et al. 2023

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Background Impact of concomitant fractures on patients sustaining a proximal femur fracture remains unclear. Rising numbers and patient need for rehab is an important issue. The objective of our study was to investigate the impact of concomitant fractures, including all types of fractures, when treated operatively, for proximal femur fractures on the length of hospital stay, in-house mortality and complication rate. Methods Observational retrospective cohort single-center study including 85 of 1933 patients (4.4%) with a mean age of 80.5 years, who were operatively treated for a proximal femoral and a concomitant fracture between January 2016 and June 2020. A matched pair analysis based on age, sex, fracture type and anticoagulants was performed. Patient data, length of hospital stay, complications and mortality were evaluated. Results The most common fractures were osteoporosis-associated fractures of the distal forearm (n = 34) and the proximal humerus (n = 36). The group of concomitant fractures showed a higher CCI than the control group (5.87 vs. 5.7 points; p < 0.67). Patients with a concurrent fracture had a longer hospital stay than patients with an isolated hip fracture (15.68 vs. 13.72 days; p < 0.056). Complications occurred more often in the group treated only for the hip fracture (11.8%, N = 20), whilst only 7.1% of complications were recorded for concomitant fractures (p < 0.084). The in-house mortality rate was 2.4% and there was no difference between patients with or without a concomitant fracture. Conclusions A concomitant fracture to a hip fracture increases the length of hospital stay significantly but does not increase the complication rate or the in-house mortality. This might be due to the early mobilization, which is possible after early operative treatment of both fractures.

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