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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....
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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