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Because of the fatal effects of bone cement implantation syndrome, the safety of cement utilization to enhance implant firmness in the femur is controversial. The aim of this study was to investigate the postoperative survival of elderly patients receiving HHA with and without cement fixation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Claim data from the National Health Insurance Database and the National Register of Deaths Database were used for analysis in this retrospective cohort study. From 2008 to 2014, 25,862 patients aged 80\u2009years or older treated with hip hemiarthroplasty were included in the analysis. A Cox proportional risk model was used to analyse the effects of cement utilization on postoperative mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cemented group had a significantly higher mortality risk than the non-cemented group within 7, 30, 180\u2009days and 1\u2009year after the operation. The effect of bone cement on postoperative mortality was significantly stronger within 7\u2009days than within 30, 180\u2009days and 1\u2009year. In addition, the male gender, age\u2009&gt;\u200985\u2009years and higher score on the Charlson Comorbidity Index were also risk factors for mortality (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Patients who received HHA in lower-volume hospitals had higher mortality rates within 180\u2009days and 1\u2009year than those in higher-volume hospitals. Compared with patients who were operated on by high-volume surgeons, those who received surgery performed by lower-volume surgeons were more likely to die within 30\u2009days (aHR\u2009=\u20091.22), 180\u2009days (aHR\u2009=\u20091.16) and 1\u2009year (aHR\u2009=\u20091.19), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The postoperative mortality rate of elderly patients undergoing HHA was significantly higher in the cemented group than in the non-cemented group.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12891-019-3013-2","type":"journal-article","created":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T15:02:44Z","timestamp":1577458964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The effects of cement fixation on survival in elderly patients with hip hemiarthroplasty: a nationwide cohort study"],"prefix":"10.1186","volume":"20","author":[{"given":"Ming-Che","family":"Tsai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yee-Yung","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Wen","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8051-0769","authenticated-orcid":false,"given":"Shiao-Chi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,12,27]]},"reference":[{"issue":"10","key":"3013_CR1","first-page":"1422","volume":"92","author":"B MPJvd","year":"2010","unstructured":"MPJvd B, Hilverdink EF, Sierevelt IN, EMBP R, Schnater JM, Bonke H, et al. 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As this study is labelled as retrospective there is no need for consent to participate to be obtained, and it has been approved as an exempt research by the ethics committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no any financial and non-financial competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"628"}}