Predictors of outcomes after internal fixation of periprosthetic femoral hip fractures Subgroup analysis of the peri-implant and peri-prosthetic fractures Spanish registry (PIPPAS).
Andrés-Peiró José Vicente, Nomdedéu Josep, Aguado Héctor J, González-Morgado Diego, Minguell-Monyart Joan, Joshi-Jubert Nayana, Teixidor-Serra Jordi, Tomàs-Hernández Jordi, Selga-Marsà Jordi, García-Sánchez Yaiza, Noriega-González David C, Mateos-Álvarez Elvira, Pereda-Manso Adela, Cervera-Díaz M Carmen, Balvis-Balvis Patricia, García-Pérez Ángela, Rodríguez-Arenas Mónica, Castro-Menéndez Manuel, Moreta Jesús, Olías-López Beatriz, Amaya-Espinosa Patricia, Boluda-Mengod Juan, Bárcena-Goitilandia Leopoldo, Blas-Dobón José Antonio, Freile-Pazmiño Patricio, Castillón Pablo, Lanuza-Lagunilla Lucía, Cabria-Fernández Julián, Valle-Cruz José, García-Coiradas Javier, Bonome-Roel César, Cano-Leira María de Los Ángeles, Benjumea-Carrasco Antonio, Chico-García Marcos, Fernández-Juan Alexis, Saura-Sánchez Eladio, Sánchez-Gómez Plácido, Ricón-Recarey Francisco Javier, García-García Elena María, Medrano-Morte Isabel, Cuadrado-Abajo Francisco, Pérez-Núñez María I, García-González Sara, Pozo-Manrique Pedro Del, García-Navas-García Francisco Manuel, García-Paredero Ester, Guijarro-Valtueña Ainhoa, Navas-Pernía Inés, Videla-Cés Miquel, Muñoz-Vives Josep M, Querolt-Coll Jordi, Triana-López de Santamaría Guillermo, Serra-Porta Teresa, Carrasco-Becerra M Carmen, Pena-Paz Silvia, Otero-Naveiro Víctor, Fernández-Dorado Fátima, Martínez-Menduiña Amaia, Galián-Muñoz Elena, Hernández José M, Renau-Cerrillo Marina, Campuzano-Bitterling Borja, Carreras-Castañer Anna, Vives-Barquiel Marian, Camacho-Carrasco Pilar, Jornet-Gibert Montsant, Muñoz-Vicente Adrián, Gámez-Asunción Carla, Plaza-Salazar Nuria, Benito-Santamaría Jennifer, Cuenca-Copete Alejandro, Alonso-Viana Laura, Mingo-Robinet Juan, Briso-Montiano Ricardo, Barbería-Biurrun Amaya, Chouza-Montero Laura, Ojeda-Thies Cristina, Ajuria-Fernández Eliam, Díaz-Suárez Rebeca, Gasset-Teixidor Alfons, Domínguez-Ibarrola Andrea, Gosálbez Javier, Pérez-Hevia Imanol, Riera-Álvarez Luís, Roche-Albero Adrián, Macho-Mier María, Criado-Albillos Guillermo, Cabello-Benavides Hugo Gabriel, Cunchillos-Pascual Jorge, Saló-Cuenca José Carlos, Espona-Roselló Jordi, Salamanca-Ontiveros César, García-Portabella Pablo, Martínez-Íñiguez Blasco Jorge, Sevilla-Ortega Paloma, Cano-Porras Juan Ramón, Martínez-Díaz Santos, Carabelli Guido Sebastián, Slullitel Pablo, Astore Ignacio, Hernández-Pascual Carlos, Marín-Sánchez Javier, Córdova-Peralta Julio C, Sánchez-Hernández Natalia, García-García Guillermo, Rodríguez-Gangoso Alfredo, Pérez-Sánchez José María, Piñeiro-Borrero Ana, Mandía-Martínez Alfonso, De Caso-Rodríguez Julio, Benito-Mateo Miguel, Murillo-Vizuete Antonio D, Herrán-Núnez Gaspar De La, Nunes-Ugarte Nahikari, Pérez-Salazar Nicolás Elizalde, De Sande-Díaz María, García-Fuentes Xoan D, de Cortázar-Antolín Unai García, Sánchez Daniel Escobar, PIPPAS Study Group
СтатьяМногоцентровое исследованиеПеревод в очереди
Аннотация
PURPOSE: To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems.
METHODS
Prospective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay).
RESULTS
One-year mortality was 16.2%. Age-adjusted Charlson Comorbidity Index score (OR=1.17; 95%CI=1.03-1.33)), Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) score (OR=1.16; 1.06-1.28), prosthetic dysfunction (OR=1.90; 1.00-3.61), and postoperative medical complications (OR=1.97; 1.06-3.68) were predictors of mortality. Patients with prior prosthetic dysfunction, lower Pfeiffer SPMSQ scores, Vancouver A fractures, and fractures fixed only using cerclages were at higher risk of local complications, which occurred in 9.3% of cases. Medical (OR=1.81; 1.05-3.13) and local complications (OR=5.56; 2.42-3.13) emerged as consistent risk factors for new institutionalization. Average hospitalization time was 13.9±9.2 days. Each day of fixation delay led to an average 1.4-day increase in total hospitalization.
CONCLUSION
Frail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization.
Для цитирования: Andrés-Peiró José Vicente, Nomdedéu Josep, Aguado Héctor J, González-Morgado Diego, Minguell-Monyart Joan, Joshi-Jubert Nayana, Teixidor-Serra Jordi, Tomàs-Hernández Jordi, Selga-Marsà Jordi, García-Sánchez Yaiza, Noriega-González David C, Mateos-Álvarez Elvira, Pereda-Manso Adela, Cervera-Díaz M Carmen, Balvis-Balvis Patricia, García-Pérez Ángela, Rodríguez-Arenas Mónica, Castro-Menéndez Manuel, Moreta Jesús, Olías-López Beatriz, Amaya-Espinosa Patricia, Boluda-Mengod Juan, Bárcena-Goitilandia Leopoldo, Blas-Dobón José Antonio, Freile-Pazmiño Patricio, Castillón Pablo, Lanuza-Lagunilla Lucía, Cabria-Fernández Julián, Valle-Cruz José, García-Coiradas Javier, Bonome-Roel César, Cano-Leira María de Los Ángeles, Benjumea-Carrasco Antonio, Chico-García Marcos, Fernández-Juan Alexis, Saura-Sánchez Eladio, Sánchez-Gómez Plácido, Ricón-Recarey Francisco Javier, García-García Elena María, Medrano-Morte Isabel, Cuadrado-Abajo Francisco, Pérez-Núñez María I, García-González Sara, Pozo-Manrique Pedro Del, García-Navas-García Francisco Manuel, García-Paredero Ester, Guijarro-Valtueña Ainhoa, Navas-Pernía Inés, Videla-Cés Miquel, Muñoz-Vives Josep M, Querolt-Coll Jordi, Triana-López de Santamaría Guillermo, Serra-Porta Teresa, Carrasco-Becerra M Carmen, Pena-Paz Silvia, Otero-Naveiro Víctor, Fernández-Dorado Fátima, Martínez-Menduiña Amaia, Galián-Muñoz Elena, Hernández José M, Renau-Cerrillo Marina, Campuzano-Bitterling Borja, Carreras-Castañer Anna, Vives-Barquiel Marian, Camacho-Carrasco Pilar, Jornet-Gibert Montsant, Muñoz-Vicente Adrián, Gámez-Asunción Carla, Plaza-Salazar Nuria, Benito-Santamaría Jennifer, Cuenca-Copete Alejandro, Alonso-Viana Laura, Mingo-Robinet Juan, Briso-Montiano Ricardo, Barbería-Biurrun Amaya, Chouza-Montero Laura, Ojeda-Thies Cristina, Ajuria-Fernández Eliam, Díaz-Suárez Rebeca, Gasset-Teixidor Alfons, Domínguez-Ibarrola Andrea, Gosálbez Javier, Pérez-Hevia Imanol, Riera-Álvarez Luís, Roche-Albero Adrián, Macho-Mier María, Criado-Albillos Guillermo, Cabello-Benavides Hugo Gabriel, Cunchillos-Pascual Jorge, Saló-Cuenca José Carlos, Espona-Roselló Jordi, Salamanca-Ontiveros César, García-Portabella Pablo, Martínez-Íñiguez Blasco Jorge, Sevilla-Ortega Paloma, Cano-Porras Juan Ramón, Martínez-Díaz Santos, Carabelli Guido Sebastián, Slullitel Pablo, Astore Ignacio, Hernández-Pascual Carlos, Marín-Sánchez Javier, Córdova-Peralta Julio C, Sánchez-Hernández Natalia, García-García Guillermo, Rodríguez-Gangoso Alfredo, Pérez-Sánchez José María, Piñeiro-Borrero Ana, Mandía-Martínez Alfonso, De Caso-Rodríguez Julio, Benito-Mateo Miguel, Murillo-Vizuete Antonio D, Herrán-Núnez Gaspar De La, Nunes-Ugarte Nahikari, Pérez-Salazar Nicolás Elizalde, De Sande-Díaz María, García-Fuentes Xoan D, de Cortázar-Antolín Unai García, Sánchez Daniel Escobar, PIPPAS Study Group. Predictors of outcomes after internal fixation of periprosthetic femoral hip fractures Subgroup analysis of the peri-implant and peri-prosthetic fractures Spanish registry (PIPPAS).. Injury. 2024. DOI: 10.1016/j.injury.2024.111715.
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