168497 20260209162330.0 doi 10.3390/jcm14175986 sideral 147959 ART-2025-147959 eng Aguado, Héctor J. Risk Factors and Predictors of 1-Year Mortality in 262 Vancouver Type C Periprosthetic Femoral Fractures: Insights from the PIPPAS Prospective Multicenter Observational Study 2025 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. Access copy available to the general public Unrestricted info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Roche Albero, Adrián Universidad de Zaragoza (orcid)0000-0001-7441-8731 PIPPAS Study Group 1013 830 Universidad de Zaragoza Dpto. Cirugía Área Traumatología y Ortopedia 14, 17 (2025), 5986 [23 pp.] J. clin.med. Journal of Clinical Medicine 2077-0383 1226183 http://zaguan.unizar.es/record/168497/files/texto_completo.pdf Versión publicada 2573597 http://zaguan.unizar.es/record/168497/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:168497 articulos driver 2026-02-09-14:42:11 ARTICLE