OBJECTIVES:  To estimate the burden of reoperation rate (clinical and economic) of hip fractures in São Paulo (Brazil). These fractures are associated with different implications to the patient, such as, high mortality rate in the first year (up to 24%), loss of function (after one year less than 40% of patients are able to walk again) and reoperation (6.3 %).

METHODS:  A longitudinal analysis was performed (2008-2015), using hospitalization records - without patient identification, the Hospitalization Service (SIH) of DATASUS, which is a real world evidence database. RESULTS:  29,188 primary and 1,903 reoperation procedures were performed in the period, resulting in an average reoperation rate of 6.5%. In 91.5% of the cases a second procedure operation was needed. 49% of the reoperation procedures were performed in the first year after primary surgery, 26% in the second year and 24% the third year. The procedures in people over 50 years correspond to 69.9% of primary procedures. Up to 50 years, women represent 40.1% of cases. Over 50 years the relationship man vs. woman is inverted and 77.8% of surgical cases for fracture treatment were performed on women. The average length of stay of patients was 6.7 days. The mortality rate was 3.72 for the surgical treatment of subtrochanteric fracture, 3.68 for transtrochanteric fracture and 1.15 for surgical treatment of delay on consolidation in the trochanteric region. The economic impact of reoperations was R $ 3.8 million (Reais) in the period studied CONCLUSIONS:  The complications related to hip fracture often require reoperation. The reoperation rate found in SUS is similar to the reoperation rate published in the literature, 6.5% vs. 6.3%. Our research shows that hip fractures represent a huge burden in the State of São Paulo in terms of reoperation and it brings a huge cost to the health care system