Rheumatoid arthritis increases complication risks in elderly hip fracture patients: A Japanese nationwide medical claims database study

Objectives: This study aimed to evaluate the outcomes and complications associated with hip fractures in patients with rheumatoid arthritis (RA) relative to those without RA. Methods: Using the Japanese National Administrative Diagnosis Procedure Combination database, we examined cases of hip fractures from April 2016 to March 2023. After one to three propensity score matching for age, sex, and complications, we examined the association between RA, complications, and mortality during hospitalization in elderly patients with hip fractures. Results: The findings revealed that elderly Japanese RA patients with hip fractures had significantly higher complications of pneumonia than elderly hip fracture patients without RA, with a ratio of 1.232 [95% confidence interval (CI): 1.065-1.426, P =. 0056], and pulmonary embolism, with a ratio of 1.155 (95% CI: 1.036-1.287, P =. 009) in multivariate logistic regression analyses. Although not significantly elevated, it also found a trend towards higher mortality during hospitalization, with a ratio of 1.179 (95% CI: 0.973-1.429, P =. 096). Conclusions: This study revealed a significant association between RA and increased complications, including pneumonia and pulmonary embolism in hip fractures in the elderly. Implementing preventive strategies is essential to minimizing complications in the treatment of hip fractures in patients with RA.