Low BMD and high alcohol consumption predict a major re-operation in patients younger than 70 years of age with a displaced femoral neck fracture—A two –year follow up study in 120 patients

Campenfeldt, Pierre; Al-Ani, Amer N.; Hedström, Margareta; Ekström, Wilhelmina

doi:10.1016/j.injury.2018.09.025

Cited by 9 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After applying propensity score weights that included relevant clinical variables, those with co-occurring risky alcohol use and smoking also had the highest odds of reoperation, readmission, and surgical complications relative to those who only smoked or only drank alcohol at risky levels, highlighting the compounding risks of these 2 behaviors on surgical health. Risky alcohol use and smoking are already well-documented surgical risk factors, 13,15,[31][32][33][34][35][36] associated with increased health care utilization and costs after surgery, 37 and even postoperative mortality. 13,14 This study extends this literature by demonstrating the combined risks of these 2 behaviors.…”

Section: Discussionmentioning

confidence: 99%

Adverse Surgical Outcomes Linked to Co-occurring Smoking and Risky Alcohol Use Among General Surgery Patients

et al. 2022

View full text Add to dashboard Cite

Objective: To assess associations between co-occurring preoperative smoking and risky alcohol use on the likelihood of adverse surgical outcomes. Background: Risky alcohol use and smoking are the known surgical risk factors with a high co-occurrence and additive adverse effects on multiple organ systems that impact surgical health, yet no research has evaluated the impact of co-occurrence on surgical outcomes. Methods: This investigation analyzed 200,816 patients from the Michigan Surgical Quality Collaborative database between July 1, 2012, to December 31, 2018. Patients were classified based on past year risky alcohol use (>2 drink/day) and cigarette smoking into 4 groups: (1) risky alcohol and smoking, (2) risky alcohol only, (3) smoking only, and (4) no risky alcohol/smoking. We fitted logistic regression models, applying propensity score weights incorporating demographic, clinical, and surgical factors to assess associations between alcohol and smoking and 30-day postoperative outcomes; surgical complications, readmission, reoperation, and emergency department (ED) visits. Results: Risky alcohol and smoking, risky alcohol only, and smoking only were reported by 2852 (1.4%), 2840 (1.4%), and 44,042 (22%) patients, respectively. Relative to all other groups, the alcohol and smoking group had greater odds of surgical complications, readmission, and reoperation. Relative to the no alcohol and smoking group, the alcohol only group higher odds of reoperation and smoking only group had higher odds of emergency department visits. Conclusions: The combination of smoking and risky drinking conferred the highest likelihood of complications, readmission, and reoperation before surgery. Co-occurring alcohol and smoking at the time of surgery warrants special attention as a patient risk factor and deserves additional research.

show abstract

Section: Discussionmentioning

confidence: 99%

Adverse Surgical Outcomes Linked to Co-occurring Smoking and Risky Alcohol Use Among General Surgery Patients

et al. 2022

View full text Add to dashboard Cite

show abstract

“…According to HHS the majority had a good or excellent hip function 10 years after the fracture, i.e., similar to the HHS score at the 24-month follow-up in the same cohort [9] . In a 12-month follow-up study of 153 patients with FNF, Frihagen et al [36] found a HHS that was significantly lower if re-operated.…”

Section: Article In Pressmentioning

confidence: 53%

Function, sarcopenia and osteoporosis 10 years after a femoral neck fracture in patients younger than 70 years

Campenfeldt

Al-Ani

Ekström

et al. 2022

Injury

Self Cite

View full text Add to dashboard Cite

Background and purpose: A femoral neck fracture (FNF) may have long-term effects on the patient's function, also in patients younger than 70 years. These long-term effects are not well described, since most studies have short follow-ups. The aim of this study was to investigate clinical outcome by performancebased functional tests, hand grip strength, and hip function in different subgroups. The secondary aim was to study surgical complications, bone mineral density (BMD) and occurrence of sarcopenia 10 years after a FNF. Patients and methods: A prospective multicenter study with a 10-year follow-up of patients aged 20-69 years with a FNF treated with internal fixation (IF). Five-times sit-to-stand test (5TSST), 4-m walking speed test, hand grip strength (HGS) and Harris Hip Score (HHS) were performed.A radiographic examination of the hip was performed and re-operations were registered. Bone mineral density (BMD) at the hip, spine and total body composition were assessed with dual energy x-ray absorptiometry (DXA). Present sarcopenia was determined by the combination of reduced functional performance and low fat-free mass index (FFMI). Results: A total of 58 patients were included. 5TSTS was normal in 45% of the patients and old age was associated with poorer performance ( p < 0.001). 76% of the study population had a normal speed gait and likewise, old age ( p = 0.005) and walking aids ( p = 0.001) were associated with poor performance. HGS was normal in 82% of the men and 64% of the women. HHS showed that 85% had a good/excellent function. A major re-operation was performed in 34% of the patients with displaced FNF and in 20% of patients with non-displaced FNF. 74% displayed osteopenia and 12% osteoporosis. 17% of the men and 38% of the women had sarcopenia. Interpretation: The majority of patients less than 70 years of age with a FNF treated with IF, had normal functional tests, muscle strength and a good hip function ten years post-operatively. However, one in ten had osteoporosis, and one third was sarcopenic which indicate the importance of encouraging regular muscle preserving resistance training after hip fracture.

show abstract

“…Baseline clinical data were derived from medical and follow-up records (16) and included age (17), sex, body mass index (BMI), injury site, tobacco use, alcohol use (18), cause of injury, preoperative blood tests (19)(20)(21), classification of Submitted Jun 21, 2020. Accepted for publication Nov 27, 2020. doi: 10.21037/atm- View this article at: http://dx.doi.org/10.21037/atm-20-4866 risk of anesthesia according to the American Association of Anesthesiologists (ASA) classification, Charlson's weighted index of comorbidities (WIC), injury severity score (ISS) score, cerebrovascular disease, interval to surgery, preoperative Garden classification, Pauwels angle (22), postoperative Garden index, postoperative interval to partial weight-bearing, postoperative interval to full weightbearing, and six-month postoperative Harris hip score.…”

Section: Patient Populationmentioning

confidence: 99%

Development and validation of a predictive nomogram for postoperative osteonecrosis of the femoral head with cannulated screws fixation

Zhu¹,

Xie²,

Zhang³

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

Background: Osteonecrosis of the femoral head (ONFH) remains a major complication of femoral neck fractures. Early interventions require preliminary prediction and detection. In this study, we aimed to evaluate the perioperative variables of postoperative ONFH in femoral neck fracture patients with closed reduction and cannulated screw fixation. We also established and validated an individualized nomogram for the prediction of postoperative ONFH. Methods: We included 470 patients with ONFH from two hospitals [First Affiliated Hospital of University of Science and Technology of China (n=360) and Southern Branch of the First Affiliated Hospital of the University of Science and Technology of China (n=110)]. We evaluated the prognostic value of multiple perioperative variables using a Cox regression model in the training cohort. We developed a nomogram for the prediction of ONFH using a logistic regression model. We assessed the performance of this nomogram in a validation cohort and evaluated its clinical value.Results: Of the 470 patients who met the inclusion criteria, 141 (30.0%) developed postoperative ONFH.

show abstract

Low BMD and high alcohol consumption predict a major re-operation in patients younger than 70 years of age with a displaced femoral neck fracture—A two –year follow up study in 120 patients

Cited by 9 publications

References 28 publications

Adverse Surgical Outcomes Linked to Co-occurring Smoking and Risky Alcohol Use Among General Surgery Patients

Adverse Surgical Outcomes Linked to Co-occurring Smoking and Risky Alcohol Use Among General Surgery Patients

Function, sarcopenia and osteoporosis 10 years after a femoral neck fracture in patients younger than 70 years

Development and validation of a predictive nomogram for postoperative osteonecrosis of the femoral head with cannulated screws fixation

Contact Info

Product

Resources

About