Background and Aims Hip fractures are a serious health concern and a major contributor to healthcare resource utilization. We aimed to investigate nationwide trends in the United States in demographics and outcomes in patients after hip fracture repair surgery.

Methods After Institutional Review Board approval (IRB#2012-050), we identified patients who underwent hip fracture repair surgery (internal fixation, hemiarthroplasty, or total hip arthroplasty) in the Premier Healthcare Database from 2016 to 2021. Patient demographics, comorbidities, complications, and anesthetic and surgical details were analyzed. Cochran–Armitage trend tests and simple linear regression were used to determine trends.

Results We identified 347,086 hip fracture surgical repair cases. The proportion of femoral neck relative to multi-location, pertrochanteric, and subtrochanteric fractures, increased. General anesthesia as the sole anesthetic trended downward (68.9% to 56.8%; P =.01). The use of peripheral nerve block stayed stable (5.6% to 5.7%). The incidence in preexisting comorbid conditions either increased or did not significantly change for all Elixhauser comorbidities, with the exception of valvular disease, which decreased. Regarding major complications (measured in counts per 1000 inpatient days), decreased rates were seen for acute myocardial infarction (from 1.71 to 1.29; p=0.032), other cardiac complications (from 12.59 to 10.67; p=0.043), pneumonia (from 4.17 to 2.72; p<.001), and pulmonary complications (from 9.54 to 6.78; p=0.032). Mortality did not change. (table 1)

Conclusions From 2016 to 2021, the overall comorbidity burden increased among patients undergoing hip fracture repair surgery. Throughout this same period, incidence of postoperative complications either remained constant or declined. Moreover, use of general anesthesia decreased over time.