Epidemiology, treatment, and mortality of femoral neck fractures in patients over the age of 65 years: a nationwide retrospective cohort study of 83,789 cases in Turkey

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dc.contributor.authorDemirel, Mehmet
dc.contributor.authorBirinci, Murat
dc.contributor.authorHakyemez, Ömer Serdar
dc.contributor.authorAzboy, Nesrullah
dc.contributor.authorBingöl, İzzet
dc.contributor.authorAzboy, İbrahim
dc.contributor.authorŞen, Cengiz
dc.date.accessioned2026-04-15T10:12:41Z
dc.date.available2026-04-15T10:12:41Z
dc.date.issued2025
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractBackground: A population-based study delineating the epidemiologic, clinical, and treatment characteristics of femoral neck fractures (FNFs) in elderly patients has not yet been conducted in Turkey. In this nationwide study, the epidemiologic, clinical, and treatment characteristics of patients aged ⩾65 years with FNFs who underwent osteosynthesis, hemiarthroplasty (HA), or total hip arthroplasty (THA) were examined. Methods: Patients aged ⩾65 years with FNFs were identified in this retrospective, nationwide study. Then, the patients who underwent osteosynthesis or total/hemiarthroplasty from 2016 to 2021 were included. All the outcome variables were collected from patient medical records stored in the e-health database of the Republic of Turkey Ministry of Health. Results: A total of 83,789 FNFs treated surgically were analysed. Osteosynthesis was performed on 21,130 FNFs (25.2%), HA on 56,378 FNFs (67.3%), and THA on 6281 FNFs (7.5%). From 2016 to 2021, the overall revision rates for THA and HA were 14.6% (914/5367 patients) and 5.9% (3301/53,077 patients), respectively. The rate of revision prosthetic surgery was significantly higher after THA than after HA (p < 0.001). Mortality rates at 1 year were 25% (n = 5293) for osteosynthesis, 14.7% (n = 924) for THA, and 71.1% (n = 40,109) for HA (p = 0.001). The multivariate model of 1-year postoperative mortality revealed 7 independent predictors: male sex (odds ratio [OR] 1.694; 95% confidence interval [CI], 1.640–1.751), use of a cemented femoral stem (OR 1.182; 95% CI, 1.117–1.250), acute myocardial infarction (AMI) (OR 1.317; 95% CI, 1.240–1.400), cerebrovascular accident (CVA) (OR 1.379; 95% CI, 1.333–1.425), chronic liver disease (CLD) (OR 2.188; 95% CI, 1.802–2.489), diabetes mellitus (DM) (OR, 1.160; 95% CI, 1.122–1.200), and age >81.50 years (OR 2.654; 95% CI, 2.569–2.742). Conclusions: Our study suggested that a hemiarthroplasty is the most common treatment modality for FNF followed by osteosynthesis (25.2%) and THA (7.5%) in Turkey. Revision rates after THA for FNF are concerning. The 1-year mortality rates are highest after HA, followed by osteosynthesis and THA. Male sex, cemented fixation, CVA, CLD, liver failure, DM, and age >81.50 are the independent predictive factors for postoperative 1-year mortality in this specific group of patients.
dc.identifier.citationDemirel, M., Birinci, M., Hakyemez, Ö. S., Azboy, N., Bingöl, İ., Azboy, İ. ... Şen, C. (2025). Epidemiology, treatment, and mortality of femoral neck fractures in patients over the age of 65 years: a nationwide retrospective cohort study of 83,789 cases in Turkey. HIP International, 35(3), 278-289. http://dx.doi.org/10.1177/11207000241312887
dc.identifier.doi10.1177/11207000241312887
dc.identifier.endpage289
dc.identifier.issn1120-7000
dc.identifier.issn1724-6067
dc.identifier.issue3
dc.identifier.pmid39865721
dc.identifier.scopus2-s2.0-85216510447
dc.identifier.scopusqualityQ1
dc.identifier.startpage278
dc.identifier.urihttp://dx.doi.org/10.1177/11207000241312887
dc.identifier.urihttps://hdl.handle.net/20.500.12511/13424
dc.identifier.volume35
dc.identifier.wosWOS:001408348700001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAzboy, İbrahim
dc.institutionauthorid0000-0003-0926-3029
dc.language.isoen
dc.relation.ispartofHIP International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectElderly
dc.subjectEpidemiology
dc.subjectFemoral Neck Fractures
dc.subjectIndependent Predictive Factors
dc.subjectMortality
dc.subjectTreatment
dc.titleEpidemiology, treatment, and mortality of femoral neck fractures in patients over the age of 65 years: a nationwide retrospective cohort study of 83,789 cases in Turkey
dc.typeArticle

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