Comorbidities, substance abuse, weight and age are independent risk factors for postoperative complications following operation for proximal humerus fractures: a retrospective analysis of 1109 patients.
Epidemiology
Postoperative complications
Proximal humerus fractures
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
07
01
2021
accepted:
23
06
2021
pubmed:
15
7
2021
medline:
17
9
2022
entrez:
14
7
2021
Statut:
ppublish
Résumé
This study aimed to investigate the influence of epidemiologic parameters on complications that needed operative revision of operatively treated proximal humerus fractures. We performed a retrospective single-center study in a level 1 trauma center. We included all patients with operatively treated proximal humerus fractures from January 1 2005 to December 31 2015. We characterized our cohort and subgroup using descriptive statistics. The primary outcome was postoperative complications. For this purpose, postoperative complications were defined in advance, an operative revision was necessary on a general rule. The secondary outcome was a model of the risk factors for complications created with multiple logistic regression. We included 1109 patients. The average age was 67.2 years (± 16.4), and 71.4% of the fractures occurred in women. A total of 644 patients (58.1%) had between one to three comorbidities, and 27.8% had four or more. The fracture morphology was as follows: 3 part 41.8%, 4 part 26.9%, 2 part 24.3%, and dislocation fracture 6.7%. Complications occurred in 150 patients (13.5%). The number of comorbidities [odds ratio (OR) 2.85, p < 0.01], body weight (OR 1.15, p = 0.02), and substance abuse (OR 1.82, p = 0.04) significantly correlated with the risk of complications. We achieved a sensitivity of 48% and a specificity of 74% for the variables body weight, substance abuse, age, and comorbidities CONCLUSION: The epidemiologic parameters, comorbidities, substance abuse, weight, and age are independent risk factors for complications. If these factors are present, one can predict a postoperative complication requiring surgical revision with low sensitivity and moderate specificity. Therefore, concerning the high number of multi-morbid patients with proximal humerus fractures, an increased postoperative complication rate can be expected. Level of evidence IV.
Identifiants
pubmed: 34258658
doi: 10.1007/s00402-021-04022-8
pii: 10.1007/s00402-021-04022-8
pmc: PMC9474377
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2701-2709Informations de copyright
© 2021. The Author(s).
Références
Clin Orthop Relat Res. 2003 Oct;(415):139-47
pubmed: 14612640
J Orthop Trauma. 2021 Mar 1;35(3):111-119
pubmed: 33079841
J Shoulder Elbow Surg. 2016 Apr;25(4):624-631.e3
pubmed: 26686759
Geriatr Orthop Surg Rehabil. 2018 Jan 25;9:2151458517750516
pubmed: 29399372
J Bone Joint Surg Am. 2009 Jun;91(6):1320-8
pubmed: 19487508
J Orthop Traumatol. 2017 Sep;18(3):265-274
pubmed: 28421293
J Shoulder Elbow Surg. 2014 Oct;23(10):1419-26
pubmed: 25086490
J Orthop. 2018 Aug 16;15(3):889-893
pubmed: 30166806
Acta Orthop Scand. 2001 Aug;72(4):365-71
pubmed: 11580125
J Shoulder Elbow Surg. 2016 Oct;25(10):e295-303
pubmed: 27079217
J Orthop Trauma. 2015 Aug;29(8):e242-4
pubmed: 25714441
J Shoulder Elbow Surg. 2014 Mar;23(3):369-76
pubmed: 24291047
JAMA. 2015 Mar 10;313(10):1037-47
pubmed: 25756440
J Am Acad Orthop Surg. 2019 Mar 15;27(6):e249-e257
pubmed: 30499892
J Shoulder Elbow Surg. 2015 Oct;24(10):1602-6
pubmed: 26163280
J Gerontol A Biol Sci Med Sci. 2017 Oct 01;72(10):1390-1393
pubmed: 28475669
J Shoulder Elbow Surg. 2018 Aug;27(8):1526-1534
pubmed: 29735376
J Bone Joint Surg Am. 2009 Mar 1;91(3):613-9
pubmed: 19255221
Cochrane Database Syst Rev. 2015 Nov 11;(11):CD000434
pubmed: 26560014
J Bone Joint Surg Am. 2014 Sep 17;96(18):1544-51
pubmed: 25232078
J Orthop Sci. 2013 May;18(3):465-70
pubmed: 23420342
J Bone Joint Surg Am. 1970 Sep;52(6):1077-89
pubmed: 5455339
Eur J Orthop Surg Traumatol. 2014 Jul;24(5):747-52
pubmed: 24253956
J Shoulder Elbow Surg. 2021 Jan;30(1):80-88
pubmed: 33317705
J Bone Miner Res. 2002 May;17(5):817-25
pubmed: 12009012
JSES Int. 2020 Dec 16;5(2):212-219
pubmed: 33681840