Predisposing factors for contralateral hip fractures in elderly patients over 80 years old

Abstract

Objectives: This study aims to identify risk factors associated with contralateral hip fractures in elderly patients over 80 years old following an initial hip fracture.

Patients and methods: Between May 2015 and April 2018, a total of 1,138 elderly patients (303 males, 805 females; median age: 85 years; interquartile range [IQR], 82 to 88 years) who were hospitalized for hip fractures were retrospectively analyzed. Data on demographics, comorbidities, and biochemical markers were collected during the initial hospitalization. Patients were followed for up to two years to identify cases of contralateral hip fractures. Risk factors were analyzed using univariate analyses and a Cox proportional hazards model using odds ratios (ORs) and confidence intervals (CIs).

Results: Of the patients, 98 (8.61%) experienced a contralateral hip fracture within two years. The incidence rates at 12 months and 24 months were 4.3% and 8.61%, respectively. Multivariable analysis identified chronic obstructive pulmonary disease (OR = 0.393, 95% CI 0.183-0.841), increasing Charlson Comorbidity Index (OR = 1.308, 95% CI 1.029-1.662), lower extremity deep vein thrombosis (OR = 0.168, 95% CI 0.079-0.354), pneumonia (OR = 0.133, 95% CI 0.075-0.236), and urinary tract infection (OR = 0.113, 95% CI 0.058-0.220) as significant risk factors for contralateral hip fractures.

Conclusion: Several key risk factors were found to be associated with contralateral hip fractures in elderly patients over 80 years old. Specifically, chronic obstructive pulmonary disease, increased Charlson Comorbidity Index, lower extremity deep vein thrombosis, pneumonia, and urinary tract infections significantly increased the risk of contralateral hip fractures. These findings highlight the importance of comprehensive assessment and targeted interventions in high-risk patients to mitigate the risk of subsequent fractures. Our results underscore the need for early identification of at-risk individuals and the implementation of preventive strategies to improve patient outcomes.

Citation: Ma LP, Cui BC, Li JQ, Tian ZX. Predisposing factors for contralateral hip fractures in elderly patients over 80 years old. Jt Dis Relat Surg 2026;37(2):314-324. doi: 10.52312/jdrs.2026.2290.

L.P.M., B.C.C., J.Q.L., Z.X.T.: Study design, data acquisition, data analysis and interpretation, manuscript preparation, manuscript review; Z.X.T.: Critical revision of the manuscript for intellectual content.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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