Complications and associated risk factors after surgical management of proximal femoral fractures

Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Nike Walter [verfasserIn] Dominik Szymski [verfasserIn] Steven M. Kurtz [verfasserIn] David W. Lowenberg [verfasserIn] Volker Alt [verfasserIn] Edmund C. Lau [verfasserIn] Markus Rupp [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension

Übergeordnetes Werk:	In: Bone & Joint Open - The British Editorial Society of Bone & Joint Surgery, 2020, 4(2023), 10, Seite 801-807
Übergeordnetes Werk:	volume:4 ; year:2023 ; number:10 ; pages:801-807

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1302/2633-1462.410.BJO-2023-0088.R1

Katalog-ID:	DOAJ09683322X

Internformat


LEADER	01000naa a22002652 4500
001	DOAJ09683322X
003	DE-627
005	20240413162940.0
007	cr uuu---uuuuu
008	240413s2023 xx \|\|\|\|\|o 00\| \|\|eng c
024	7		\|a 10.1302/2633-1462.410.BJO-2023-0088.R1 \|2 doi
035			\|a (DE-627)DOAJ09683322X
035			\|a (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921
040			\|a DE-627 \|b ger \|c DE-627 \|e rakwb
041			\|a eng
050		0	\|a RD701-811
100	0		\|a Nike Walter \|e verfasserin \|4 aut
245	1	0	\|a Complications and associated risk factors after surgical management of proximal femoral fractures
264		1	\|c 2023
336			\|a Text \|b txt \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
520			\|a Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.
650		4	\|a proximal femur fracture
650		4	\|a risk factors
650		4	\|a complications
650		4	\|a union failure
650		4	\|a fracture-related infection
650		4	\|a proximal femur fractures (pffs)
650		4	\|a fracture-related infections
650		4	\|a intertrochanteric fractures
650		4	\|a subtrochanteric fractures
650		4	\|a mechanical complications
650		4	\|a neck fractures
650		4	\|a femoral fractures
650		4	\|a infection
650		4	\|a rheumatoid disease
650		4	\|a hypertension
653		0	\|a Orthopedic surgery
700	0		\|a Dominik Szymski \|e verfasserin \|4 aut
700	0		\|a Steven M. Kurtz \|e verfasserin \|4 aut
700	0		\|a David W. Lowenberg \|e verfasserin \|4 aut
700	0		\|a Volker Alt \|e verfasserin \|4 aut
700	0		\|a Edmund C. Lau \|e verfasserin \|4 aut
700	0		\|a Markus Rupp \|e verfasserin \|4 aut
773	0	8	\|i In \|t Bone & Joint Open \|d The British Editorial Society of Bone & Joint Surgery, 2020 \|g 4(2023), 10, Seite 801-807 \|w (DE-627)1694585433 \|x 26331462 \|7 nnns
773	1	8	\|g volume:4 \|g year:2023 \|g number:10 \|g pages:801-807
856	4	0	\|u https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 \|z kostenfrei
856	4	0	\|u https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 \|z kostenfrei
856	4	0	\|u https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 \|z kostenfrei
856	4	2	\|u https://doaj.org/toc/2633-1462 \|y Journal toc \|z kostenfrei
912			\|a GBV_USEFLAG_A
912			\|a SYSFLAG_A
912			\|a GBV_DOAJ
912			\|a GBV_ILN_20
912			\|a GBV_ILN_22
912			\|a GBV_ILN_24
912			\|a GBV_ILN_31
912			\|a GBV_ILN_39
912			\|a GBV_ILN_40
912			\|a GBV_ILN_62
912			\|a GBV_ILN_63
912			\|a GBV_ILN_65
912			\|a GBV_ILN_69
912			\|a GBV_ILN_73
912			\|a GBV_ILN_95
912			\|a GBV_ILN_105
912			\|a GBV_ILN_110
912			\|a GBV_ILN_151
912			\|a GBV_ILN_161
912			\|a GBV_ILN_213
912			\|a GBV_ILN_230
912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_602
912			\|a GBV_ILN_2014
912			\|a GBV_ILN_4012
912			\|a GBV_ILN_4037
912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4249
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4306
912			\|a GBV_ILN_4307
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4322
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4338
912			\|a GBV_ILN_4367
912			\|a GBV_ILN_4700
951			\|a AR
952			\|d 4 \|j 2023 \|e 10 \|h 801-807

Indexfelder

author_variant	n w nw d s ds s m k smk d w l dwl v a va e c l ecl m r mr
matchkey_str	article:26331462:2023----::opiainadsoitdikatratrugclaaeetf
hierarchy_sort_str	2023
callnumber-subject-code	RD
publishDate	2023
allfields	10.1302/2633-1462.410.BJO-2023-0088.R1 doi (DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921 DE-627 ger DE-627 rakwb eng RD701-811 Nike Walter verfasserin aut Complications and associated risk factors after surgical management of proximal femoral fractures 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery Dominik Szymski verfasserin aut Steven M. Kurtz verfasserin aut David W. Lowenberg verfasserin aut Volker Alt verfasserin aut Edmund C. Lau verfasserin aut Markus Rupp verfasserin aut In Bone & Joint Open The British Editorial Society of Bone & Joint Surgery, 2020 4(2023), 10, Seite 801-807 (DE-627)1694585433 26331462 nnns volume:4 year:2023 number:10 pages:801-807 https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 kostenfrei https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/toc/2633-1462 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2023 10 801-807
spelling	10.1302/2633-1462.410.BJO-2023-0088.R1 doi (DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921 DE-627 ger DE-627 rakwb eng RD701-811 Nike Walter verfasserin aut Complications and associated risk factors after surgical management of proximal femoral fractures 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery Dominik Szymski verfasserin aut Steven M. Kurtz verfasserin aut David W. Lowenberg verfasserin aut Volker Alt verfasserin aut Edmund C. Lau verfasserin aut Markus Rupp verfasserin aut In Bone & Joint Open The British Editorial Society of Bone & Joint Surgery, 2020 4(2023), 10, Seite 801-807 (DE-627)1694585433 26331462 nnns volume:4 year:2023 number:10 pages:801-807 https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 kostenfrei https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/toc/2633-1462 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2023 10 801-807
allfields_unstemmed	10.1302/2633-1462.410.BJO-2023-0088.R1 doi (DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921 DE-627 ger DE-627 rakwb eng RD701-811 Nike Walter verfasserin aut Complications and associated risk factors after surgical management of proximal femoral fractures 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery Dominik Szymski verfasserin aut Steven M. Kurtz verfasserin aut David W. Lowenberg verfasserin aut Volker Alt verfasserin aut Edmund C. Lau verfasserin aut Markus Rupp verfasserin aut In Bone & Joint Open The British Editorial Society of Bone & Joint Surgery, 2020 4(2023), 10, Seite 801-807 (DE-627)1694585433 26331462 nnns volume:4 year:2023 number:10 pages:801-807 https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 kostenfrei https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/toc/2633-1462 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2023 10 801-807
allfieldsGer	10.1302/2633-1462.410.BJO-2023-0088.R1 doi (DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921 DE-627 ger DE-627 rakwb eng RD701-811 Nike Walter verfasserin aut Complications and associated risk factors after surgical management of proximal femoral fractures 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery Dominik Szymski verfasserin aut Steven M. Kurtz verfasserin aut David W. Lowenberg verfasserin aut Volker Alt verfasserin aut Edmund C. Lau verfasserin aut Markus Rupp verfasserin aut In Bone & Joint Open The British Editorial Society of Bone & Joint Surgery, 2020 4(2023), 10, Seite 801-807 (DE-627)1694585433 26331462 nnns volume:4 year:2023 number:10 pages:801-807 https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 kostenfrei https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/toc/2633-1462 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2023 10 801-807
allfieldsSound	10.1302/2633-1462.410.BJO-2023-0088.R1 doi (DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921 DE-627 ger DE-627 rakwb eng RD701-811 Nike Walter verfasserin aut Complications and associated risk factors after surgical management of proximal femoral fractures 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807. proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery Dominik Szymski verfasserin aut Steven M. Kurtz verfasserin aut David W. Lowenberg verfasserin aut Volker Alt verfasserin aut Edmund C. Lau verfasserin aut Markus Rupp verfasserin aut In Bone & Joint Open The British Editorial Society of Bone & Joint Surgery, 2020 4(2023), 10, Seite 801-807 (DE-627)1694585433 26331462 nnns volume:4 year:2023 number:10 pages:801-807 https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 kostenfrei https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 kostenfrei https://doaj.org/toc/2633-1462 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2023 10 801-807
language	English
source	In Bone & Joint Open 4(2023), 10, Seite 801-807 volume:4 year:2023 number:10 pages:801-807
sourceStr	In Bone & Joint Open 4(2023), 10, Seite 801-807 volume:4 year:2023 number:10 pages:801-807
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension Orthopedic surgery
isfreeaccess_bool	true
container_title	Bone & Joint Open
authorswithroles_txt_mv	Nike Walter @@aut@@ Dominik Szymski @@aut@@ Steven M. Kurtz @@aut@@ David W. Lowenberg @@aut@@ Volker Alt @@aut@@ Edmund C. Lau @@aut@@ Markus Rupp @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	1694585433
id	DOAJ09683322X
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">DOAJ09683322X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240413162940.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240413s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ09683322X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD701-811</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Nike Walter</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Complications and associated risk factors after surgical management of proximal femoral fractures</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">proximal femur fracture</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">risk factors</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">complications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">union failure</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">fracture-related infection</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">proximal femur fractures (pffs)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">fracture-related infections</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">intertrochanteric fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">subtrochanteric fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">mechanical complications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">neck fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">femoral fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">infection</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">rheumatoid disease</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">hypertension</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Orthopedic surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Dominik Szymski</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Steven M. Kurtz</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">David W. Lowenberg</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Volker Alt</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Edmund C. Lau</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Markus Rupp</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Bone & Joint Open</subfield><subfield code="d">The British Editorial Society of Bone & Joint Surgery, 2020</subfield><subfield code="g">4(2023), 10, Seite 801-807</subfield><subfield code="w">(DE-627)1694585433</subfield><subfield code="x">26331462</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:4</subfield><subfield code="g">year:2023</subfield><subfield code="g">number:10</subfield><subfield code="g">pages:801-807</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/2633-1462</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4367</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">4</subfield><subfield code="j">2023</subfield><subfield code="e">10</subfield><subfield code="h">801-807</subfield></datafield></record></collection>
callnumber-first	R - Medicine
author	Nike Walter
spellingShingle	Nike Walter misc RD701-811 misc proximal femur fracture misc risk factors misc complications misc union failure misc fracture-related infection misc proximal femur fractures (pffs) misc fracture-related infections misc intertrochanteric fractures misc subtrochanteric fractures misc mechanical complications misc neck fractures misc femoral fractures misc infection misc rheumatoid disease misc hypertension misc Orthopedic surgery Complications and associated risk factors after surgical management of proximal femoral fractures
authorStr	Nike Walter
ppnlink_with_tag_str_mv	@@773@@(DE-627)1694585433
format	electronic Article
delete_txt_mv	keep
author_role	aut aut aut aut aut aut aut
collection	DOAJ
remote_str	true
callnumber-label	RD701-811
illustrated	Not Illustrated
issn	26331462
topic_title	RD701-811 Complications and associated risk factors after surgical management of proximal femoral fractures proximal femur fracture risk factors complications union failure fracture-related infection proximal femur fractures (pffs) fracture-related infections intertrochanteric fractures subtrochanteric fractures mechanical complications neck fractures femoral fractures infection rheumatoid disease hypertension
topic	misc RD701-811 misc proximal femur fracture misc risk factors misc complications misc union failure misc fracture-related infection misc proximal femur fractures (pffs) misc fracture-related infections misc intertrochanteric fractures misc subtrochanteric fractures misc mechanical complications misc neck fractures misc femoral fractures misc infection misc rheumatoid disease misc hypertension misc Orthopedic surgery
topic_unstemmed	misc RD701-811 misc proximal femur fracture misc risk factors misc complications misc union failure misc fracture-related infection misc proximal femur fractures (pffs) misc fracture-related infections misc intertrochanteric fractures misc subtrochanteric fractures misc mechanical complications misc neck fractures misc femoral fractures misc infection misc rheumatoid disease misc hypertension misc Orthopedic surgery
topic_browse	misc RD701-811 misc proximal femur fracture misc risk factors misc complications misc union failure misc fracture-related infection misc proximal femur fractures (pffs) misc fracture-related infections misc intertrochanteric fractures misc subtrochanteric fractures misc mechanical complications misc neck fractures misc femoral fractures misc infection misc rheumatoid disease misc hypertension misc Orthopedic surgery
format_facet	Elektronische Aufsätze Aufsätze Elektronische Ressource
format_main_str_mv	Text Zeitschrift/Artikel
carriertype_str_mv	cr
hierarchy_parent_title	Bone & Joint Open
hierarchy_parent_id	1694585433
hierarchy_top_title	Bone & Joint Open
isfreeaccess_txt	true
familylinks_str_mv	(DE-627)1694585433
title	Complications and associated risk factors after surgical management of proximal femoral fractures
ctrlnum	(DE-627)DOAJ09683322X (DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921
title_full	Complications and associated risk factors after surgical management of proximal femoral fractures
author_sort	Nike Walter
journal	Bone & Joint Open
journalStr	Bone & Joint Open
callnumber-first-code	R
lang_code	eng
isOA_bool	true
recordtype	marc
publishDateSort	2023
contenttype_str_mv	txt
container_start_page	801
author_browse	Nike Walter Dominik Szymski Steven M. Kurtz David W. Lowenberg Volker Alt Edmund C. Lau Markus Rupp
container_volume	4
class	RD701-811
format_se	Elektronische Aufsätze
author-letter	Nike Walter
doi_str_mv	10.1302/2633-1462.410.BJO-2023-0088.R1
author2-role	verfasserin
title_sort	complications and associated risk factors after surgical management of proximal femoral fractures
callnumber	RD701-811
title_auth	Complications and associated risk factors after surgical management of proximal femoral fractures
abstract	Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.
abstractGer	Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.
abstract_unstemmed	Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.
collection_details	GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700
container_issue	10
title_short	Complications and associated risk factors after surgical management of proximal femoral fractures
url	https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1 https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921 https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1 https://doaj.org/toc/2633-1462
remote_bool	true
author2	Dominik Szymski Steven M. Kurtz David W. Lowenberg Volker Alt Edmund C. Lau Markus Rupp
author2Str	Dominik Szymski Steven M. Kurtz David W. Lowenberg Volker Alt Edmund C. Lau Markus Rupp
ppnlink	1694585433
callnumber-subject	RD - Surgery
mediatype_str_mv	c
isOA_txt	true
hochschulschrift_bool	false
doi_str	10.1302/2633-1462.410.BJO-2023-0088.R1
callnumber-a	RD701-811
up_date	2024-07-03T22:33:08.700Z
_version_	1803598942651285504
fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">DOAJ09683322X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240413162940.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240413s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ09683322X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJa8a71d6d401c4aab8183e4a54458e921</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD701-811</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Nike Walter</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Complications and associated risk factors after surgical management of proximal femoral fractures</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Aims: This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Methods: Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Results: Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). Conclusion: The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management. Cite this article: Bone Jt Open 2023;4(10):801–807.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">proximal femur fracture</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">risk factors</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">complications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">union failure</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">fracture-related infection</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">proximal femur fractures (pffs)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">fracture-related infections</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">intertrochanteric fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">subtrochanteric fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">mechanical complications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">neck fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">femoral fractures</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">infection</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">rheumatoid disease</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">hypertension</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Orthopedic surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Dominik Szymski</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Steven M. Kurtz</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">David W. Lowenberg</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Volker Alt</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Edmund C. Lau</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Markus Rupp</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Bone & Joint Open</subfield><subfield code="d">The British Editorial Society of Bone & Joint Surgery, 2020</subfield><subfield code="g">4(2023), 10, Seite 801-807</subfield><subfield code="w">(DE-627)1694585433</subfield><subfield code="x">26331462</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:4</subfield><subfield code="g">year:2023</subfield><subfield code="g">number:10</subfield><subfield code="g">pages:801-807</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/a8a71d6d401c4aab8183e4a54458e921</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0088.R1</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/2633-1462</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4367</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">4</subfield><subfield code="j">2023</subfield><subfield code="e">10</subfield><subfield code="h">801-807</subfield></datafield></record></collection>
score	7.3999157

Nicht das Richtige dabei?

Schreiben Sie uns!

Complications and associated risk factors after surgical management of proximal femoral fractures

Nicht das Richtige dabei?

Zugang & Verfügbarkeit

Vorhandene Bände

Nicht das Richtige dabei?