Impact of concomitant injuries in geriatric patients with proximal femur fracture

Abstract

Aims The impact of concomitant injuries in patients with proximal femoral fractures has rarely been studied. To date, the few studies published have been mostly single-centre research focusing on the influence of upper limb fractures. A retrospective cohort analysis was, therefore, conducted to identify the impact and distribution of concomitant injuries in patients with proximal femoral fractures. Methods A retrospective, multicentre registry-based study was undertaken. Between 1 January 2016 and 31 December 2019, data for 24,919 patients from 100 hospitals were collected in the Registry for Geriatric Trauma. This information was queried and patient groups with and without concomitant injury were compared using linear and logistic regression models. In addition, we analyzed the influence of the different types of additional injuries. Results A total of 22,602 patients met the inclusion criteria. The overall prevalence of a concomitant injury was 8.2% with a predominance of female patients (8.7% vs 6.9%; p < 0.001). Most common were fractures of the ipsilateral upper limb. Concomitant injuries resulted in prolonged time-to-surgery (by 3.4 hours (95 confidence interval (CI) 2.14 to 4.69)) and extended length of stay in hospital by 2.2 days (95% CI 1.74 to 2.61). Mortality during the admission was significantly higher in the concomitant injury group (7.4% vs 5.3%; p < 0.001). Additionally, walking ability and quality of life were reduced in these patients at discharge. More patients were discharged to a nursing home instead of their own home compared to patients without additional injuries (25.8% vs 30.3%; p < 0.001). Conclusion With a prevalence of 8.2%, the appearance of a concomitant injury is common in elderly patients with hip fracture. These patients are at a greater risk for death during the admission, longer hospital stays, and delayed surgery. This knowledge is clinically important for all who are involved in the treatment of proximal femur fractures. Cite this article: Bone Joint J 2021;103-B(9):1526–1533.

Clinical application of upper limb fracture fixator in emergency treatment of upper limb fracture

“…While increasing patient comfort, it prevents pressure injuries and is suitable for long-term contact with the skin. 16 , 17 …”

“…While increasing patient comfort, it prevents pressure injuries and is suitable for long-term contact with the skin. 16,17 The emergency department is the epitome of the overall work of the hospital, which can directly reflect the quality of emergency medical care and nursing work in the hospital. It occupies a substantial position in the modern emergency medical system.…”

Good quality research in many subspecialties

“…At the other end of the spectrum, we see important ongoing work looking at how best to use registry data. [9][10][11][12][13][14][15][16] There is clearly much depth in this information that is not seen in routine registry reports, and understanding where to look, how to look, and how to generate hypotheses from the data is becoming increasingly important to those involved in this work and to the discerning trauma and orthopaedic community.…”

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

“…PFFs primarily affect elderly individuals, and comorbitant injuries are common. 1 The incidence is expected to rise as the ageing population increases. 2 Projections have estimated that the annual prevalence would heighten from 1.26 million in 1990 to 4.5 million by 2050.…”