Excess Mortality for Hip Fracture Surgery vs. Total Hip Replacement

Excess mortality among hip fracture–surgery patients above that seen in total hip–replacement patients has been ascribed largely to age and medical comorbidities. This French study was designed to explore potentially modifiable risk factors that contribute to such excess mortality. Researchers identified 117,157 patients (mean age, 75) who underwent either hip fracture surgery or hip replacement surgery; patients in each group were matched for age and a wide range of medical comorbidities. About one third of patients had chronic metabolic, cardiac, or pulmonary comorbidities.

During 4 years of follow-up, 2180 in-hospital deaths occurred in hip fracture patients and 362 such deaths occurred in hip replacement patients. Major complications (in…