Proximal humeral fracture in patients with high Charlson comorbidity index: mortality rate according to treatment choice
| Autor: | Jesús Vidal Campos, Fernando Marco Martínez, Ana Belén Fernández-Cortiñas |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
animal structures Comorbidity 03 medical and health sciences 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine In patient Surgical treatment Survival rate Retrospective Studies 030222 orthopedics business.industry Mortality rate Patient Selection Retrospective cohort study 030229 sport sciences medicine.disease Prognosis nervous system diseases Surgery Charlson comorbidity index Orthopedic surgery Shoulder Fractures business psychological phenomena and processes |
| Zdroj: | Musculoskeletal surgery. 105(2) |
| ISSN: | 2035-5114 |
| Popis: | The purpose of this study was to evaluate the relevance of a commonly used morbidity prognostic tool, the Charlson comorbidity index (CCI), in determining the survival rate of patients with isolated proximal humeral fractures (PHFs) and to determine the impact of surgical treatment according to previous comorbidities (measured with CCI). All patients who were treated for a single PHF in our institution for 29 consecutive months were included in this retrospective study, with a minimum follow-up of 24 months (mean 52.8 months). Two groups were established according to the type of treatment received (surgical versus non-surgical). Preinjury comorbidities were identified, and the age-adapted CCI was calculated. All complications and mortality rates were prospectively recorded over the complete follow-up period. Patients with elevated preinjury comorbidities (CCI > 5) demonstrated a significant increase in mortality (HR = 4.64) compared to those with CCI ≤ 5. In addition, patients with high comorbidities (CCI > 5) who underwent surgical treatment demonstrated a statistically significant increase in mortality (HR = 6.92) compared to patients with similarly high comorbidities (CCI > 5) who underwent non-surgical treatment. Patients with high preinjury comorbidities (CCI > 5) experienced an increased mortality risk if they underwent surgical treatment for isolated PHFs. The use of a morbidity prognostic tool, such as the CCI, can help predict the outcome (particularly mortality) in these patients and may aid in making decisions in terms of operative versus non-operative treatment to minimize patient mortality. Level III; Retrospective Comparative Study; Treatment Study. |
| Databáze: | OpenAIRE |
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