Background: Despite the rising global burden of mental disorders, their impact on complication risk following hip fracture surgery remains unclear. We examined reoperation and mortality risks after hip fracture surgery, investigating patients with and without moderate to severe mental disorders.
Methods: Using a nationwide cohort design, we identified patients undergoing hip fracture surgery from the Danish Multidisciplinary Hip Fracture Register. Mental disorders (including organic disorders (dementia), substance use, schizophrenia, mood disorders, and neurotic disorders) and reoperations were determined using diagnosis and procedure codes in the Danish National Patient Registry. We estimated reoperation and mortality risk with adjusted hazard ratios and 95% confidence intervals (CIs), comparing each mental disorder to no mental disorder while accounting for death as a competing risk.
Results: Among 110 625 hip fracture patients from 2004 to 2021, 15 254 (14%) had a mental disorder. The 30-day adjusted hazard ratios for reoperation ranged from 1.05 (CI: 0.9-1.2) for dementia to 1.67 (CI: 1.3-2.1) for substance use. The 365-day adjusted hazard ratios for reoperation ranged from 0.92 (CI: 0.9-1.0) for dementia to 1.37 (CI: 1.2-1.5) for neurotic disorders. Patients with mental disorders had an increased adjusted hazard ratio for mortality at both 30-day and 365-day follow-up compared to patients without mental disorders, with the most pronounced risk observed among patients with dementia.
Conclusions: The risk of reoperation and mortality following hip fracture surgery was significantly higher in patients with moderate to severe mental disorders compared to those without. These findings emphasize the need for targeted prevention strategies to reduce reoperation risk and mortality.
Keywords: Comorbidity; Complications; Hip fracture; Mental disorders; Mortality.
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