Does Intramedullary Nail Fixation of the Tibia Pose the Same Risk of Pulmonary Complications as Intramedullary Nail Fixation of the Femur? A Propensity Score-Matched Analysis.
Journal
Journal of orthopaedic trauma
ISSN: 1531-2291
Titre abrégé: J Orthop Trauma
Pays: United States
ID NLM: 8807705
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
pubmed:
22
10
2019
medline:
22
6
2021
entrez:
22
10
2019
Statut:
ppublish
Résumé
To compare duration of mechanical ventilation and pulmonary outcomes in patients treated with intramedullary nail (IMN) fixation of the tibia versus the femur. Retrospective cohort study. Level I trauma center. One thousand thirty patients were categorized based on treatment: those treated with IMN of the tibia (n = 515) and those treated with IMN of the femur (n = 515). IMN fixation of tibial and femoral fractures. The primary outcome was duration of mechanical ventilation. Secondary outcomes included length of intensive care unit (ICU) stay and risk of tracheostomy, pulmonary embolism (PE), acute respiratory distress syndrome (ARDS), and mortality. In an unadjusted analysis, femoral fractures were associated with increase in ventilator days (mean difference, 1.4; P < 0.001), ICU days (mean difference, 1.8; P < 0.001), and odds of tracheostomy (odds ratio, 1.7; P < 0.01). No difference was shown in likelihood of PE, ARDS, or mortality (P > 0.2). Propensity score-matched estimates showed no differences in any measured outcomes (P > 0.40). In patients with Injury Severity Scores >17, we found no difference in length of ventilator or ICU days or likelihood of tracheostomy, PE, ARDS, or mortality in the unadjusted (P > 0.2) or propensity score-matched estimates (P > 0.3). These findings suggest that IMN fixation of the tibia is associated with duration of mechanical ventilation and risk of poor pulmonary outcomes similar to those of femoral nailing, after adjustment for baseline characteristics. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 31634272
doi: 10.1097/BOT.0000000000001654
pii: 00005131-202002000-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e45-e50Références
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