Cargando…

Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society

Background and Objectives: The outcomes of patients with pathologic hip fractures remain unclear. Data from a large international geriatric trauma registry were analyzed to examine the outcomes of patients with pathologic hip fractures compared with patients with typical osteoporotic hip fractures....

Descripción completa

Detalles Bibliográficos
Autores principales: Bliemel, Christopher, Rascher, Katherine, Oberkircher, Ludwig, Schlosshauer, Torsten, Schoeneberg, Carsten, Knobe, Matthias, Pass, Bastian, Ruchholtz, Steffen, Klasan, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322375/
https://www.ncbi.nlm.nih.gov/pubmed/35888590
http://dx.doi.org/10.3390/medicina58070871
_version_ 1784756287783829504
author Bliemel, Christopher
Rascher, Katherine
Oberkircher, Ludwig
Schlosshauer, Torsten
Schoeneberg, Carsten
Knobe, Matthias
Pass, Bastian
Ruchholtz, Steffen
Klasan, Antonio
author_facet Bliemel, Christopher
Rascher, Katherine
Oberkircher, Ludwig
Schlosshauer, Torsten
Schoeneberg, Carsten
Knobe, Matthias
Pass, Bastian
Ruchholtz, Steffen
Klasan, Antonio
author_sort Bliemel, Christopher
collection PubMed
description Background and Objectives: The outcomes of patients with pathologic hip fractures remain unclear. Data from a large international geriatric trauma registry were analyzed to examine the outcomes of patients with pathologic hip fractures compared with patients with typical osteoporotic hip fractures. Materials and Methods: Data from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) were analyzed. All patients treated surgically for osteoporotic or pathologic hip fractures were included in this analysis. Across both fracture types, a 2:1 optimal propensity score matching and multivariate logistic regression analysis were conducted. In-house mortality rate and mortality at the 120-day follow-up, as well as mobility after 7 and 120 days, reoperation rate, discharge management from the hospital and readmission rate to the hospital until the 120-day follow-up were analyzed as outcome parameters for the underlying fracture type—pathologic or osteoporotic. Results: A total of 29,541 cases met the inclusion criteria. Of the patients included, 29,330 suffered from osteoporotic fractures, and 211 suffered from pathologic fractures. Multivariate logistic regression analysis revealed no differences between the two fracture types in terms of mortality during the acute hospital stay, reoperation during the initial acute hospital stay, walking ability after seven days and the likelihood of being discharged back home. Walking ability and hospital readmission remained insignificant at the 120-day follow-up as well. However, the odds of passing away within the first 120 days were significantly higher for patients suffering from pathologic hip fractures (OR: 3.07; p = 0.003). Conclusions: Surgical treatment of pathologic hip fractures was marked by a more frequent use of arthroplasty in per- and subtrochanteric fractures. Furthermore, the mortality rate among patients suffering from pathologic hip fractures was elevated in the midterm. The complication rate, as indicated by the rate of readmission to the hospital and the necessity for reoperation, remained unaffected.
format Online
Article
Text
id pubmed-9322375
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93223752022-07-27 Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society Bliemel, Christopher Rascher, Katherine Oberkircher, Ludwig Schlosshauer, Torsten Schoeneberg, Carsten Knobe, Matthias Pass, Bastian Ruchholtz, Steffen Klasan, Antonio Medicina (Kaunas) Article Background and Objectives: The outcomes of patients with pathologic hip fractures remain unclear. Data from a large international geriatric trauma registry were analyzed to examine the outcomes of patients with pathologic hip fractures compared with patients with typical osteoporotic hip fractures. Materials and Methods: Data from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) were analyzed. All patients treated surgically for osteoporotic or pathologic hip fractures were included in this analysis. Across both fracture types, a 2:1 optimal propensity score matching and multivariate logistic regression analysis were conducted. In-house mortality rate and mortality at the 120-day follow-up, as well as mobility after 7 and 120 days, reoperation rate, discharge management from the hospital and readmission rate to the hospital until the 120-day follow-up were analyzed as outcome parameters for the underlying fracture type—pathologic or osteoporotic. Results: A total of 29,541 cases met the inclusion criteria. Of the patients included, 29,330 suffered from osteoporotic fractures, and 211 suffered from pathologic fractures. Multivariate logistic regression analysis revealed no differences between the two fracture types in terms of mortality during the acute hospital stay, reoperation during the initial acute hospital stay, walking ability after seven days and the likelihood of being discharged back home. Walking ability and hospital readmission remained insignificant at the 120-day follow-up as well. However, the odds of passing away within the first 120 days were significantly higher for patients suffering from pathologic hip fractures (OR: 3.07; p = 0.003). Conclusions: Surgical treatment of pathologic hip fractures was marked by a more frequent use of arthroplasty in per- and subtrochanteric fractures. Furthermore, the mortality rate among patients suffering from pathologic hip fractures was elevated in the midterm. The complication rate, as indicated by the rate of readmission to the hospital and the necessity for reoperation, remained unaffected. MDPI 2022-06-29 /pmc/articles/PMC9322375/ /pubmed/35888590 http://dx.doi.org/10.3390/medicina58070871 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bliemel, Christopher
Rascher, Katherine
Oberkircher, Ludwig
Schlosshauer, Torsten
Schoeneberg, Carsten
Knobe, Matthias
Pass, Bastian
Ruchholtz, Steffen
Klasan, Antonio
Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title_full Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title_fullStr Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title_full_unstemmed Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title_short Surgical Management and Outcomes following Pathologic Hip Fracture—Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society
title_sort surgical management and outcomes following pathologic hip fracture—results from a propensity matching analysis of the registry for geriatric trauma of the german trauma society
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322375/
https://www.ncbi.nlm.nih.gov/pubmed/35888590
http://dx.doi.org/10.3390/medicina58070871
work_keys_str_mv AT bliemelchristopher surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT rascherkatherine surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT oberkircherludwig surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT schlosshauertorsten surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT schoenebergcarsten surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT knobematthias surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT passbastian surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT ruchholtzsteffen surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT klasanantonio surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety
AT surgicalmanagementandoutcomesfollowingpathologichipfractureresultsfromapropensitymatchinganalysisoftheregistryforgeriatrictraumaofthegermantraumasociety