Factors associated with one year mortality in ill patients with proximal femoral fractures treated non operatively

Injury ◽  
2021 ◽  
Author(s):  
Maria Adelaide de Miranda ◽  
Andrés Paliz Pontón ◽  
Leonardo Mousinho Guerra ◽  
Fernando Brandao Andrade-Silva ◽  
Marcos de Camargo Leonhardt ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Proximal Femoral Fractures ◽  
Factors Associated ◽  
One Year

scholarly journals Factors Influencing Mortality in Patients on Antiplatelet Agents Presenting with Proximal Femoral Fractures

2011 ◽  
Vol 19 (3) ◽  
pp. 314-316 ◽  
Author(s):  
Rohit Maheshwari ◽  
Mehool Acharya ◽  
Maureen Monda ◽  
Radhakant Pandey
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Screw Fixation ◽  
Univariate Analysis ◽  
Femoral Fractures ◽  
Antiplatelet Agents ◽  
Proximal Femoral Fractures ◽  
Postoperative Blood Transfusion ◽  
Hip Screw ◽  
One Year

Purpose. To identify factors predicting one-year mortality in patients on clopidogrel presenting with proximal femoral fractures. Methods. 9 men and 22 women aged 64 to 97 (mean, 81; standard deviation, 8) years who had been taking clopidogrel for ischaemic heart disease (n=15), cerebrovascular disease (n=6), or both (n=10) presented with proximal femoral fractures. The time from injury to operation, type of anaesthesia, treatment method, and postoperative complications were reviewed. One-year mortality was analysed using the Kaplan-Meier curve. Factors predicting one-year mortality were identified. Results. The fracture configurations of the 31 patients included intracapsular femoral neck fracture (n=17), intertrochanteric fracture (n=13), and subtrochanteric fracture (n=1). 30 of the patients underwent hemiarthroplasty (n=16), dynamic hip screw fixation (n=9) or intramedullary hip screw fixation (n=5). The remaining patient underwent conservative treatment owing to metastatic prostate cancer. Of the 30 patients who underwent surgery, clopidogrel was discontinued at least 7 days prior to surgery, with the mean delay to surgery being 8.4 (range, 2–16) days. No patient had excessive blood loss at operation, although 7 patients received a blood transfusion postoperatively. 13 (43%) patients developed postoperative complications. The one-year mortality was 26% (8/31). Univariate analysis showed that factors predicting one-year mortality were spinal anaesthesia (p=0.04), postoperative blood transfusion (p=0.03), postoperative complications (p=0.03), and delay to surgery (p=0.03). Multiple regression analysis showed that delay to surgery (p=0.03) was the only independent predictor of one-year mortality, with a hazard ratio of 1.357 (95% confidence interval, 1.03–1.79). Conclusion. Surgery should be performed as soon as possible in medically fit patients having proximal femoral fractures who are taking clopidogrel, as delay to surgery is associated with increased one-year mortality.

scholarly journals Proximal femur locking compression plate in complex proximal femoral fractures: a retrospective analysis

2016 ◽  
Vol 2 (3) ◽  
pp. 104 ◽  
Author(s):  
Rajesh Govindasamy ◽  
Ramkumar Gnanasundaram ◽  
Saravanan Kasirajan ◽  
Jimmy J Meleppuram ◽  
Kumar Archit
Keyword(s):  
Femoral Fractures ◽  
Subtrochanteric Fracture ◽  
Fracture Pattern ◽  
Locking Compression Plate ◽  
Harris Hip Score ◽  
Proximal Femoral Fractures ◽  
Compression Plate ◽  
Hip Screw ◽  
One Year ◽  
Mobility Score

<p class="abstract"><strong>Background:</strong> Proximal femoral fractures are one of the most common fractures in old age patients. Fixation of these fractures is technically high demanding owing to the high risk of complications. The aim of our study is to analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these fractures.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analyzed 18 proximal femoral fractures treated with PF-LCP from May 2012 to May 2015. There were 12 females (67%) and six males (33%) with an average age of 59.6 years (range, 32 to 84 years). The peritrochanteric fractures constituted by intertrochanteric and subtrochanteric fractures were classified by Boyd and Griffin classification along with Seinshemier’s classification, respectively. Among that, 14 cases (77%) were of intertrochanteric and four cases (23%) were of subtrochanteric fracture pattern. The functional outcome was evaluated by harris hip score and the parker palmer mobility score one year after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 18 patients, 16 patients obtained fracture union without further intervention; two patients required additional bone grafting. There were no cases of hip screw cutting the femoral head. There was no post-operative mortality in our study. The average harris hip score was 85.5 (83-94). The assessment by parker and palmar mobility score was 7.6 (range 4-9).</p><strong>Conclusions:</strong> The PF-LCP is a good stable alternative in the treatment of complex proximal femoral fractures. It provides good to excellent bone healing with limited complications.

scholarly journals Dedicated Hip Fracture Lists: Improving the Service Received by Orthopaedic Trauma Patients

2013 ◽  
Vol 95 (3) ◽  
pp. 1-3 ◽  
Author(s):  
SZ Basheer ◽  
DI Wood ◽  
K Shepherd ◽  
JC McGregor-Riley
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Femoral Fractures ◽  
Mortality Rates ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Proximal Femoral Fractures ◽  
One Year ◽  
The Uk

Proximal femoral fractures are the most common injury resulting in acute admission to an orthopaedic trauma ward. Up to 75,000 hip fractures occur per year in the UK and this is projected to rise to around 100,000 per year by 2020. These fractures occur most frequently in frail, elderly patients who have significant co-morbidities and they are consequently associated with high mortality rates of 5–10% at one month and up to 30% at one year following injury.

The Probability of A1C Goal Attainment in Patients with Uncontrolled Type-2 Diabetes in a Large Integrated Delivery System: A Prediction Model

2020 ◽  
Author(s):  
Kevin M Pantalone ◽  
Anita D Misra-Hebert ◽  
Todd M Hobbs ◽  
Sheldon X Kong ◽  
Xinge Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Goal Attainment ◽  
Index Date ◽  
Cleveland Clinic ◽  
Patient Characteristics ◽  
Psychiatric Disease ◽  
Lower Probability ◽  
Factors Associated ◽  
One Year

<b>Objective:</b> To assess patient characteristics and treatment factors associated with uncontrolled type 2 diabetes (T2D) and the probability of A1C goal attainment. <p><b>Research Design and Methods</b>: Retrospective cohort study using the electronic health record at Cleveland Clinic. Patients with uncontrolled T2D (A1C>9%) were identified on the index date of 12/31/2016 (n=6,973), grouped by attainment (n=1,653 [24.7%) or non-attainment (n=5,320 [76.3%]) of A1C<8% by 12/31/2017, and subgroups compared on a number of demographic and clinical variables. Based on these variables, a nomogram was created for predicting probability of A1C goal attainment. </p> <p><b>Results:</b> For the entire population, median age at index date was 57.7 years (53.3% male), and the majority were white (67.2%). Median A1C was 10.2%. Obesity (50.6%), cardiovascular disease (46.9%) and psychiatric disease (61.1%) were the most common comorbidities. Metformin (62.7%) and sulfonylureas (38.7%) were the most common anti-diabetes medications. Only 1,653 (24%) patients achieved an A1C <8%. Predictors of increased probability of A1C goal attainment were older age, white/non-Hispanic race/ethnicity, Medicare health insurance, lower baseline A1C, higher frequency of endocrinology/primary care visits, DPP-4i use, thiazolidinedione use, metformin use, GLP-1RA use, and fewer classes of anti-diabetes drugs. Factors associated with lower probability included insulin use and longer time in the T2D database (both presumed as likely surrogates for duration of T2D). </p> <p><b>Conclusions:</b> A minority of patients with an A1C>9% achieved an A1C<8% at one year. While most identified predictive factors are non-modifiable by the clinician, pursuit of frequent patient engagement and tailored drug regimens may help improve A1C goal attainment. </p>

scholarly journals Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 825
Author(s):  
Mansi Dhami ◽  
Felix Ogbo ◽  
Blessing Akombi-Inyang ◽  
Raphael Torome ◽  
Kingsley Agho ◽  
...  
Keyword(s):  
Young Child ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Bottle Feeding ◽  
Bibliographic Databases ◽  
Child Feeding ◽  
Factors Associated ◽  
Young Child Feeding ◽  
Semi Solid ◽  
One Year

Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.

scholarly journals Proximal Femoral Locking Compression Plate for Proximal Femoral Fractures

2014 ◽  
Vol 22 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Wei Ting Lee ◽  
Diarmuid Murphy ◽  
Fareed HY Kagda ◽  
Joseph Thambiah
Keyword(s):  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Proximal Femoral Fractures ◽  
Compression Plate
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