Goh En Lin, Khatri Amulya, Costa Alexander B, Ting Andrew, Steiner Kat, Png May Ee, Metcalfe David, Cook Jonathan A, Costa Matthew L
Oxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Department of Trauma and Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, UK.
Bone Joint J. 2025 Feb 1;107-B(2):139-148. doi: 10.1302/0301-620X.107B2.BJJ-2024-0251.R1.
Older adults with hip fractures are at high risk of experiencing complications after surgery, but estimates of the rate of specific complications vary by study design and follow-up period. The aim of this systematic review was to determine the prevalence of complications in older adults after hip fracture surgery.
MEDLINE, Embase, CINAHL, and CENTRAL databases were searched from inception until 30 June 2023. Studies were included if they reported prevalence data of complications in an unselected, consecutive population of older adults (aged ≥ 60 years) undergoing hip fracture surgery.
A total of 95 studies representing 2,521,300 patients were included. For surgery-specific complications, the 30-day prevalence of reoperation was 2.31%, surgical site infection 1.69%, and deep surgical site infection 0.98%; the 365-day prevalence of prosthesis dislocation was 1.11%, fixation failure 1.77%, and periprosthetic or peri-implant fracture 2.23%. For general complications, the 30-day prevalence of acute kidney injury was 1.21%, blood transfusion 25.55%, cerebrovascular accident 0.79%, lower respiratory tract infection 4.08%, myocardial infarction 1.98%, urinary tract infection 7.01%, and venous thromboembolism 2.15%.
Complications are prevalent in older adults who have had surgery for a hip fracture. Studies reporting complications after hip fracture surgery varied widely in terms of quality, and we advocate for the routine monitoring of complications in registries and clinical trials to improve the quality of evidence.
髋部骨折的老年人术后发生并发症的风险很高，但特定并发症发生率的估计因研究设计和随访期而异。本系统评价的目的是确定髋部骨折手术后老年人并发症的患病率。
检索MEDLINE、Embase、CINAHL和CENTRAL数据库，检索时间从建库至2023年6月30日。纳入的研究需报告在未经选择的连续老年人群（年龄≥60岁）中进行髋部骨折手术的并发症患病率数据。
共纳入95项研究，涉及2521300例患者。对于手术相关并发症，再次手术的30天患病率为2.31%，手术部位感染为1.69%，深部手术部位感染为0.98%；假体脱位的365天患病率为1.11%，内固定失败为1.77%，假体周围或植入物周围骨折为2.23%。对于一般并发症，急性肾损伤的30天患病率为1.21%，输血为25.55%，脑血管意外为0.79%，下呼吸道感染为4.08%，心肌梗死为1.98%，尿路感染为7.01%，静脉血栓栓塞为2.15%。
髋部骨折手术的老年人中并发症很常见。关于髋部骨折手术后并发症的研究在质量方面差异很大，我们提倡在登记处和临床试验中对并发症进行常规监测，以提高证据质量。
