{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:29:03Z","timestamp":1791386943856,"version":"4.3.3"},"reference-count":43,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AO Trauma Foundation (Spain)","award":["PI-20-2041"],"award-info":[{"award-number":["PI-20-2041"]}]},{"name":"AO Trauma Foundation (Spain)","award":["GRS 2371\/A\/21"],"award-info":[{"award-number":["GRS 2371\/A\/21"]}]},{"name":"AO Trauma Foundation (Spain)","award":["GRS 2794\/A1\/23"],"award-info":[{"award-number":["GRS 2794\/A1\/23"]}]},{"name":"Gerencia Regional de Salud de \u201cSalud de Castilla y Le\u00f3n\u201d (GRS SACYL)","award":["PI-20-2041"],"award-info":[{"award-number":["PI-20-2041"]}]},{"name":"Gerencia Regional de Salud de \u201cSalud de Castilla y Le\u00f3n\u201d (GRS SACYL)","award":["GRS 2371\/A\/21"],"award-info":[{"award-number":["GRS 2371\/A\/21"]}]},{"name":"Gerencia Regional de Salud de \u201cSalud de Castilla y Le\u00f3n\u201d (GRS SACYL)","award":["GRS 2794\/A1\/23"],"award-info":[{"award-number":["GRS 2794\/A1\/23"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Vancouver type C periprosthetic femoral fractures (VC-PFFs) predominantly affect frail elderly patients and are associated with high mortality, yet limited evidence exists regarding prognostic factors. The PIPPAS study (Peri-Implant and PeriProsthetic Survival Analysis) sub-analysis aimed to investigate the risk factors for one-year mortality following VC-PFF and identify predictors of medical and surgical complications. Methods: This prospective, multicenter, observational case series was conducted across 59 hospitals in Spain and involved 262 VC-PFF patients between January 2021 and April 2023 with a minimum 1-year follow-up. Demographic, clinical, management, and surgical and outcome data were collected. Logistic regression models were used to identify predictors of one-year mortality and complications. Results: One-year mortality was 30.1%. VC-PFF patients were elderly (median age 85 years, IQR (12.75)), female (77.1%) and frail: median clinical frailty scale 5, IQR (2), mild cognitive impairment (median Pfeiffer score 3, IQR (5)), and multiple comorbidities (median age-adjusted Charlson comorbidity index (a-CCI) 6, IQR (2)). Surgery was performed in 94.7% of cases, primarily with plate osteosynthesis (62.3%) or intramedullary nailing (29.1%). Male sex, higher age, frailty, cognitive impairment, ASA score, and a-CCI were significantly associated with increased mortality. Protective factors included higher hemoglobin levels, surgical treatment, and early postoperative ambulation. No significant difference in mortality was observed between fixation techniques. Conclusions: One-year mortality in VC-PFF patients is high. These findings underscore the need for individualized treatment plans and reinforce the role of early co-management and clinical optimization.<\/jats:p>","DOI":"10.3390\/jcm14175986","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T06:08:37Z","timestamp":1756102117000},"page":"5986","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk Factors and Predictors of 1-Year Mortality in 262 Vancouver Type C Periprosthetic Femoral Fractures: Insights from the PIPPAS Prospective Multicenter Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0371-520X","authenticated-orcid":false,"given":"H\u00e9ctor J.","family":"Aguado","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the PIPPAS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1302\/0301-620X.93B1.25087","article-title":"The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement","volume":"93-B","author":"Meek","year":"2011","journal-title":"J. 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