Primary and Periprosthetic Distal Femur Fractures in Older Adults: No Difference in 12-Month Mortality and Patient-Reported Outcomes.

Autor:	Mather AM; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Edwards E; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Alfred Health, Melbourne, VIC, Australia., Hau R; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.; Department of Surgery, University of Melbourne, Parkville, VIC, Australia; and., Ekegren CL; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Alfred Health, Melbourne, VIC, Australia.; School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic trauma [J Orthop Trauma] 2023 Oct 01; Vol. 37 (10), pp. 492-499.
DOI:	10.1097/BOT.0000000000002649
Abstrakt:	Objectives: To compare fracture incidence, mortality, and patient-reported health outcomes at 6 and 12 months postinjury between primary and periprosthetic distal femur fractures in older adults. Methods: A registry-based cohort study was conducted including all adults 70 years of age or older registered by the Victorian Orthopaedic Trauma Outcomes Registry who experienced a primary or periprosthetic distal femur fracture between 2007 and 2017. Outcomes included mortality and health status (Three-Level European Quality of Life-Five Dimensions Scale [EQ-5D-3L]) collected at 6 and 12 months postinjury. All distal femur fractures were confirmed by radiological review. Multivariable logistic regression was conducted to report associations between fracture type and mortality and health status. Results: A final cohort of 292 participants was identified. Overall mortality for the cohort was 29.8%, and no significant differences were found in mortality rate or EQ-5D-3L outcomes between fracture types (ie, primary vs. periprosthetic). A large proportion of participants reported problems across all EQ-5D-3L domains at 6 and 12 months postinjury, with slightly worse outcomes in the primary fracture group. Conclusions: This study reports high mortality and poor 12-month outcomes in an older adult cohort with both periprosthetic and primary distal femur fractures. Given these poor outcomes, fracture prevention and a greater focus on long-term rehabilitation is needed in this cohort. In addition, the involvement of an ortho-geriatrician should be considered as a routine component of care. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Competing Interests: The authors report no conflict of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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