"Mortality rate of geriatric acetabular fractures is high compared with" by Amir Khoshbin, Amit Atrey et al.
 

Bone and Joint Institute

Mortality rate of geriatric acetabular fractures is high compared with hip fractures. A matched cohort study

Document Type

Article

Publication Date

8-1-2020

Journal

Journal of Orthopaedic Trauma

Volume

34

Issue

8

First Page

424

Last Page

428

URL with Digital Object Identifier

10.1097/BOT.0000000000001758

Abstract

© 2020 Lippincott Williams and Wilkins. All rights reserved. Objectives:Compare acute complication and mortality rates of geriatric patients with acetabular fractures (AFs) matched to hip fractures (HFs).Design:Retrospective cohort study.Setting:American College of Surgeons National Surgical Quality Improvement Project.Patients:Using Current Procedural Terminology codes, the American College of Surgeons National Surgical Quality Improvement Project registry was used to identify all patients ≥60 years from 2011 to 2016 treated for AFs undergoing open reduction internal fixation (ORIF) and HFs (undergoing ORIF, hemiarthroplasty, or cephalomedullary nail).Outcome Measurements:Patient characteristics, comorbidities, functional status, acute complications, and mortality rates were recorded. Patients were matched 1:5 (AF:HF). Chi-square, Fisher exact, and Mann-Whitney U tests were used to compare groups, and multivariable logistic regression was used to compare the risk of complications or death while adjusting for relevant covariates.Results:A total of 303 AF patients (age: 78.2 ± 9.2 years/59.7% females/27.1% wall, 28.4% one column and 45.2% 2 columns ORIF) were matched to 1511 HF patients (age: 78.3 ± 9.1 years/60.2% females/37.2% hemiarthroplasty, 16.3% ORIF and 47.4% cephalomedullary nail). Length of stay (8.4 ± 7.1 vs. 6.4 ± 5.9 days) and time to surgery [(TS) 2.3 ± 1.8 versus 1.2 ± 1.4 days] were longer in the AF group (P < 0.01). Unadjusted mortality rates were nonsignificantly higher for AFs versus HFs (6.6% vs. 4.6%, P = 0.14). After covariable adjustment, the risk of mortality was significantly higher for AFs versus HFs (odds ratio: 1.89, 95% confidence interval: 1.07-3.35).Conclusion:Geriatric AFs pose a significantly higher adjusted mortality risk when compared with HF patients. Strategies to mitigate risk factors in this population are warranted.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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