Mortality and Revision Surgery Are Increased in Patients With Parkinson’s Disease and Fractures of the Femoral Neck

Karadsheh, Mark S.; Rodriguez, Edward K.; Harris, Mitchel B.; Zurakowski, David; Lucas, Robert E.; Weaver, Michael J.

doi:10.1007/s11999-015-4262-5

Cited by 27 publications

(34 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, PD patients were more likely to sustain a dislocation after hemiarthroplasty and fixation failure for minimally displaced fractures. 6 The reoperation rates for PD were 4% and 22% for displaced femoral neck fractures and nondisplaced fractures respectively. Although the two groups received different surgical interventions, the significantly higher reoperation rates in the nondisplaced group prompted the authors to favor the use of hemiarthroplasties for non-displaced femoral neck fractures in PD patients.…”

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 88%

“…In addition, the frail status and frequent falls exhibited in this patient population may further complicate the postoperative recovery course. 6 Lastly, the frequent resting tremors observed in PD may also have altered the healing process. In order to facilitate optimal bone healing to occur, stabilizing the fracture either through relative stability or absolute stability is essential.…”

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 99%

“…On the other hand, several reports noted an inferior outcome for PD patients after sustaining a hip fracture with mortality rates as high as 47%. 6,17 Karadsheh et al reported PD as an independent predictor of mortality after operative treatment for femoral neck fractures. Interestingly, PD patients were more likely to sustain a dislocation after hemiarthroplasty and fixation failure for minimally displaced fractures.…”

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 99%

“…3 Most of the literature suggests that PD is an independent risk factor for inferior outcomes after a hip fracture with increased risks for mortality, reoperation, surgical complications and reduced mobility. 5,6 Although hip fractures have been frequently discussed, limited studies have assessed the outcome of upper extremity fractures in PD patients. In particular, the Distal Radial Fracture (DRF) is the second most common fracture observed in this population.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The outcome for surgical fixation of distal radial fractures in patients with Idiopathic Parkinson’s Disease: a cohort study

Chou

Chang

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction : Idiopathic Parkinson’s Disease (PD) is a progressive neurologic disorder causing postural instability and unsteady gait. These patients are at increased risk for fractures and have inferior outcomes after treatment. Several studies have evaluated the incidence and outcome of PD patients after hip fractures. However, there are limited studies assessing the outcome of upper extremity fractures in these patients. In this study, we evaluated the outcome of PD patients that received surgical intervention for distal radial fractures (DRF). We hypothesize that these patients have an inferior outcome after surgery in comparison with non-PD patients. Methods : Between May 2005 through May 2017, we retrospectively reviewed all of the patients with DRF and subsequently underwent open reduction and internal fixation (ORIF) at a level 1 trauma center. All of the surgeries were performed by fellowship trained orthopedic surgeons. The inclusion criteria include patients with a definitive diagnosis of PD, non-pathological DRF and a minimum follow-up of 1 year or up until the time of treatment failure was noted. Each PD patient was matched for age and gender to 3 non-PD patients. The primary objective was to determine the failure rate after surgical fixation for DRF. The secondary outcomes include time to treatment failure, reoperation rate, readmission rate, length of hospital stay, and postoperative complications. Results : A total of 88 patients were included in this study (23 PD, 65 non-PD patients). All underwent ORIF and received standard postoperative follow-ups. The overall treatment failure rate in PD was 39.1% vs. 4.6% in the non-PD group (p<0.05). The time to treatment failure were 9.11 ± 3.86 weeks and 14.67 ± 5.8 weeks for PD and non-PD, respectively (p<0.05). PD patients had a significantly higher rate of failure when k-wires and ESF were used (p<0.05), while loss of reduction was the most common mode of failure in PD (44.4%) The length of hospital stay for PD was 5.3 ± 4.69 days compared with 3.78 ± 0.96 days for non-PD (p=0.01). There were 3 PD patients readmitted within 30 days after surgery, and 1 patient had pneumonia after the surgery. Conclusion: This study revealed that patients with PD have a high treatment failure rate despite surgical intervention for DRF. PD patients had a longer hospital stay and had a shorter time to treatment failure. In treating PD patients complicated with DRF, the surgeon must take into consideration the complex disease course of PD and the associated comorbidities such as osteoporosis, frail status, and frequent falls. Rehabilitation and disposition plans should be discussed in advance and longer hospital stays should be expected. Level of evidence: Level IV, Retrospective Cohort Study Keywords: Parkinson’s disease, distal radial fractures, osteoporosis, fracture nonunion Disclosure: We do not have any disclosures or conflicts of interest

show abstract

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 88%

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 99%

Section: The Outcome Of Fractures In Patients With Parkinson's Diseasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The outcome for surgical fixation of distal radial fractures in patients with Idiopathic Parkinson’s Disease: a cohort study

Chou

Chang

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Additionally, the incidence of periprosthetic fractures in the PD group was significantly higher than in the control group (p < 0.05). 15 Karadsheh et al 16 examined the mortality and revision rates in PD patients (141 patients) and patients who did not have PD (282 patients) who had suffered from femoral neck fractures. The rates of reoperation for both displaced and nondisplaced fractures were higher in PD patients compared with the control group (11 vs. 4%; p ¼ 0.005).…”

Section: Discussionmentioning

confidence: 99%

Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis

Katz¹,

Vakharia

Anis

et al. 2020

The Journal of Hip Surgery

View full text Add to dashboard Cite

Studies investigating the impact of Parkinson's disease (PD) on patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to investigate whether PD patients undergoing primary THA are at increased risk of: (1) medical complications; (2) implant-related complications; (3) readmissions; and (4) costs. A query was performed using an administrative claims database. Matched non-PD patients undergoing primary THA served as a control group. Non-PD patients undergoing primary THA served as a matching cohort. The query yielded 39,184 patients (PD = 9,796; control = 29,388). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Patients who have PD were found to have increased odds (4.64 vs. 1.15%; odds ratio [OR]: 4.19, 95% confidence interval [CI]: 3.60–4.87, p < 0.0001) of medical complications compared with the matched cohort. PD patients had greater odds of implant-related complications (7.12 vs. 3.99; OR: 1.84, p < 0.0001). PD patients also had significantly higher odds of 90-day readmission (19.83 vs. 15.29%; OR: 1.37, 95% CI: 1.29–1.45, p < 0.0001) and incurred greater 90-day costs of care ($20,143 vs. $16,905, p < 0.0001). The results of the study demonstrate that PD is an independent risk factor for medical complications, implant-related complications, readmission rates, and increased costs of care following a primary THA. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.

show abstract

Parkinson’s disease and hip fractures: Are complications and mortality rates increased?

Müller

Doblinger

Füchtmeier

2020

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Mortality and Revision Surgery Are Increased in Patients With Parkinson’s Disease and Fractures of the Femoral Neck

Cited by 27 publications

References 40 publications

The outcome for surgical fixation of distal radial fractures in patients with Idiopathic Parkinson’s Disease: a cohort study

The outcome for surgical fixation of distal radial fractures in patients with Idiopathic Parkinson’s Disease: a cohort study

Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis

Parkinson’s disease and hip fractures: Are complications and mortality rates increased?

Contact Info

Product

Resources

About