Christopher Bliemel1, Katherine Rascher2, Ludwig Oberkircher3, Torsten Schlosshauer4, Carsten Schoeneberg5, Matthias Knobe6, Bastian Pass5, Steffen Ruchholtz1, Antonio Klasan7. 1. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen-Marburg, Baldingerstrasse, 35043 Marburg, Germany. 2. Akademie der Unfallchirurgie GmbH, 80538 Munich, Germany. 3. Department of Trauma Surgery, Orthopaedics and Arthroplasty, Hospital Friedrichshafen, 88048 Friedrichshafen, Germany. 4. Department of Plastic Surgery, Agaplesion Evangelical Hospital Giessen, 35398 Gießen, Germany. 5. Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital Essen, 45131 Essen, Germany. 6. Department of Orthopaedic and Trauma Surgery, Cantone Hospital Lucerne,6004 Luzern, Switzerland. 7. Department for Orthopaedics and Traumatology, Kepler University Hospital Linz, 4020 Linz, Austria.
Abstract
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.
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.
Authors: Matthew T Houdek; Cody C Wyles; Joshua R Labott; Peter S Rose; Michael J Taunton; Franklin H Sim Journal: J Arthroplasty Date: 2017-07-05 Impact factor: 4.757
Authors: Norah Harvey; Elke R Ahlmann; Daniel C Allison; Lingjun Wang; Lawrence R Menendez Journal: Clin Orthop Relat Res Date: 2012-03 Impact factor: 4.176