Reoperation in the year following hip fracture:a nationwide cohort in England

<b>Aim:</b><br/>To characterise hip fracture reoperation in the year after index native hip fracture in England.<br/><br/><b>Methods</b>:<br/>Hip fracture presentations at 159 English hospitals, over 3 years (2016-2019), among patients aged 60 years and older, were identified and linked with anonymised data from routinely collected data sources (Hospital Episodes Statistics, Civil Death Registration, National Hip Fracture Database), and followed-up to 365 days. Office of Population Censuses and Surveys (OPCS) Classification of Interventions and Procedures codes identified all hip reoperations and descriptive statistics were calculated. <br/><br/><b>Results</b>:<br/>Of 164,691 patients presenting with an index hip fracture the mean age was 83 years (standard deviation 8.6), and 70.8% were female. Over the following 365 days 7,522 (4.6%) had at least one hip reoperation, but this varied from 2.3% to 9.4% between hospital sites. Reoperation was most frequent for people with subtrochanteric fractures fixed with a cephalomedullary nail at 7.2%. The commonest indication for reoperation within 30 days of index surgery was infection, but after 30 days it was fracture around the implant. Reoperation was less common among older patients: patients aged 90+ years had a reoperation risk of 3.7%, compared to 6.2% for patients aged 60-69 years. A total of 44,947 people (27.3%) died within 365 days of the index presentation, but mortality was similar for those who did and did not have a reoperation (28% vs. 27.3%). <br/><br/><b>Conclusion</b>:<br/>Reoperation after hip fracture surgery is common. These novel data can enable informed shared decision-making for this high-risk population.