Proximal Humeral Fractures

Spross, Christian; Jost, Bernhard

doi:10.1007/978-3-319-70099-1_5

Cited by 1 publication

(2 citation statements)

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“…17 Such findings resulted in divided opinion, sparking criticism and debates on the optimal PHF treatment. 18…”

Section: Introductionmentioning

confidence: 99%

“…17 Such findings resulted in divided opinion, sparking criticism and debates on the optimal PHF treatment. 18 Thus, we aimed to answer the following questions based on broad nationwide data: 1) what is the overall incidence rate, as well as the age-and sex-specific incidence rates of PHFs in the elderly population in the USA; 2) what is the mortality rate after fracture of the proximal humerus in the elderly population in general and specifically for distinct treatment procedures; and 3) what clinical, demographic, and community-level socioeconomic factors influence the post-fracture mortality rate?…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Proximal humerus fractures – epidemiology, comparison of mortality rates after surgical versus non-surgical treatment, and analysis of risk factors based on Medicare registry data

Walter

Szymski

Kurtz

et al. 2023

Bone & Joint Research

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Aims The optimal choice of management for proximal humerus fractures (PHFs) has been increasingly discussed in the literature, and this work aimed to answer the following questions: 1) what are the incidence rates of PHF in the geriatric population in the USA; 2) what is the mortality rate after PHF in the elderly population, specifically for distinct treatment procedures; and 3) what factors influence the mortality rate? Methods PHFs occurring between 1 January 2009 and 31 December 2019 were identified from the Medicare physician service records. Incidence rates were determined, mortality rates were calculated, and semiparametric Cox regression was applied, incorporating 23 demographic, clinical, and socioeconomic covariates, to compare the mortality risk between treatments. Results From 2009 to 2019, the incidence decreased by 11.85% from 300.4 cases/100,000 enrollees to 266.3 cases/100,000 enrollees, although this was not statistically significant (z = -1.47, p = 0.142). In comparison to matched Medicare patients without a PHF, but of the same five-year age group and sex, a mean survival difference of -17.3% was observed. The one-year mortality rate was higher after nonoperative treatment with 16.4% compared to surgical treatment with 9.3% (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.23 to 1.36; p < 0.001) and to shoulder arthroplasty with 7.4% (HR = 1.45, 95% CI 1.33 to 1.58; p < 0.001). Statistically significant mortality risk factors after operative treatment included age older than 75 years, male sex, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, chronic kidney disease, a concomitant fracture, congestive heart failure, and osteoporotic fracture. Conclusion Mortality risk factors for distinct treatment modes after PHF in elderly patients could be identified, which may guide clinical decision-making. Cite this article: Bone Joint Res 2023;12(2):103–112.

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“…17 Such findings resulted in divided opinion, sparking criticism and debates on the optimal PHF treatment. 18…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%