Cervical Hip Fractures: Trends in Surgical Treatment in Region Örebro County

Abstract: Introduction: Approximately 8,000 patients suffer from cervical hip fractures in Sweden every year. Recommended treatment is surgery by either osteosynthesis or arthroplasty. Aim: To analyze possible differences in patient and fracture characteristics, time to treatment, choice of surgical treatment and outcome in patients treated for cervical hip fractures in Region Örebro County between the years of 2014 to 2019. Method: The population included 713 patients treated for cervical hip fractures in Region Örebro County who were registered into the Swedish Fracture Register. Data analyzed was patient characteristics (gender, age, injury classification), treatment year, time to treatment, treatment method, and 90-day mortality. Predictors of 90-day mortality were studied by univariate- and multivariate logistic regression. Results: There were no significant differences in patient characteristics over the period, whereas time to surgery increased. In 2014 50.3% were treated with arthroplasty compared to 77.8% in 2019 (p < 0.01). Overall mortality was 15.7% in the osteosynthesis group and 10.5% in the arthroplasty group (p = 0.04). No statistically significant difference was found in total 90-day mortality between the years 2014 and 2019 (p = 0.25). Statistically significantly increased risk of 90-day mortality was noted for males (OR [Odds Ratio] = 2.87), increasing age (OR = 1.09) and treatment with osteosynthesis (OR = 1.68). Conclusions: The choice of treatment for cervical hip fractures shifted in Region Örebro County between 2014 and 2019 towards more arthroplasty, although patient characteristics remained the same and time to surgery increased, overall yielding no statistically significant difference in 90-day mortality.