scholarly journals Nutritional Status and Temporal Changes in the Walking Ability of Femoral Neck Fracture Patients

2015 ◽  
Vol 30 (4) ◽  
pp. 523-527
Author(s):  
Nobuhiro OKAMOTO ◽  
Shin MASUMI ◽  
Masatoshi MIZUTANI ◽  
Keisuke SAITOH ◽  
Kazuhiro HARADA ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Nutritional Status ◽  
Femoral Neck Fracture ◽  
Temporal Changes ◽  
Walking Ability ◽  
Neck Fracture

scholarly journals Effect of nutritional status before femoral neck fracture surgery on postoperative outcomes: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katsuya Yokoyama ◽  
Taku Ukai ◽  
Masahiko Watanabe
Keyword(s):  
Femoral Neck ◽  
Nutritional Status ◽  
Femoral Neck Fracture ◽  
Transfer Rate ◽  
Normal Group ◽  
Postoperative Outcomes ◽  
Transfusion Rate ◽  
Neck Fracture ◽  
Gait Function ◽  
Fracture Surgery

Abstract Background Although nutritional status is crucial in gait recovery after femoral neck fracture surgery, the relationship between preoperative nutritional status and postoperative outcomes remains unknown. This study examined the effects of preoperative nutritional status on postoperative outcomes in patients undergoing femoral neck fracture surgery. Methods Data regarding the joints of 137 patients (29 men, 108 women) who underwent bipolar hemiarthroplasty for femoral neck fractures at our hospital from January 2015 to December 2019 were retrospectively examined. The Geriatric Nutritional Risk Index (GNRI), an index of nutritional status, was used to classify patients into two groups: a normal group (GNRI ≥92; n = 62) and an undernourished group (GNRI < 92; n = 75). The study endpoints included age at surgery, sex, Mini Mental State Examination (MMSE), American Society of Anesthesiologists Physical Status (ASA) classification, preoperative waiting period, intraoperative blood loss, surgery time, perioperative hemoglobin levels, blood transfusion rate, complication rate, 6-month mortality rate, transfer rate, percentage of patients unable to walk at discharge or transfer, and inability to walk 6 months postoperatively. Results The patients in the undernourished group was significantly older at surgery (p < 0.01) and had a lower perioperative hemoglobin levels (p < 0.01), a higher blood transfusion rate (p < 0.01), a lower MMSE (p < 0.01), a longer preoperative waiting period (p < 0.05), a higher transfer rate (p < 0.05), were more likely to be unable to walk 6 months postoperatively (p < 0.01), a higher complication rate (p < 0.05), and a higher 6-month mortality rate (p < 0.01) than the normal group. Patients in the undernourished group had worse rates of postoperative complications, transfer, mortality, and inability to walk 6-month after surgery than those in the normal group. Conclusions A poor nutritional status affects the gait function and systemic condition of patients undergoing femoral neck fracture surgery; therefore, early nutritional interventions may reduce mortality rates and shorten rehabilitation. These results suggest that the GNRI effectively predicts postoperative complications, mortality, and gait function.

scholarly journals Rapid preoperative predicting tools for 1-year mortality and walking ability of Asian elderly femoral neck fracture patients who planned for hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guangtao Fu ◽  
Mengyuan Li ◽  
Yunlian Xue ◽  
Hao Wang ◽  
Ruiying Zhang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Arthroplasty ◽  
External Validation ◽  
Femoral Neck Fractures ◽  
Screening Tests ◽  
Walking Ability ◽  
Validation Group ◽  
Data Set ◽  
Neck Fracture

Abstract Background Femoral neck fractures in elderly patients typically warrant operative treatment and are related to high risks of mortality and morbidity. As early hip arthroplasties for elderly femoral neck fractures are widely accepted, rapid predicting models that allowed quantitative and individualized prognosis assessments are strongly needed as references for orthopedic surgeons during preoperative conversations. Methods Data of patients aged ≥ 65 years old who underwent primary unilateral hemiarthroplasty or total hip arthroplasty due to femoral neck fracture between January 1st, 2012 and June 30th, 2019 in our center were collected. Candidate variables included demographic data, comorbidities, and routine preoperative screening tests. The main outcomes included 1-year mortality and free walking rate after hip arthroplasty. Patients were randomly divided into derivation and validation groups in the ratio of three to one. Nomograms were developed based on multivariable logistic regressions of derivation group via R language. One thousand bootstraps were used for internal validation. Those models were further tested in the validation group for external validation. Results The final analysis was performed on 702 patients after exclusion and follow-up. All-cause 1-year mortality of the entire data set was 23.4%, while the free walking rate was 57.3%. Preoperative walking ability showed the biggest impact on predicting 1-year mortality and walking ability. Static nomograms were created from the final multivariable models, which allowed simplified graphical computations for the risks of 1-year mortality and walking ability in a certain patient. The bias-corrected C index of those nomograms for predicting 1-year mortality in the derivation group and the validation group were 0.789 and 0.768, while they were 0.807 and 0.759 for predicting postoperative walking ability. The AUC of the mortality and walking ability predicting models were 0.791 and 0.818, respectively. Conclusions Our models enabled rapid preoperative 1-year mortality and walking ability predictions in Asian elderly femoral neck fracture patients who planned for hip arthroplasty, with adequate predictive discrimination and calibration. Those rapid assessment models could help surgeons in making more reasonable clinical decisions and subsequently reducing the risk of potential medical dispute via quantitative and individualized prognosis assessments.

scholarly journals Walking Ability after Femoral Neck Fracture.

1995 ◽  
Vol 44 (1) ◽  
pp. 269-272
Author(s):  
Norimasa Sunakawa ◽  
Tsutomu Teruya ◽  
Hiroaki Hanzawa ◽  
Fuminori Kanaya ◽  
Tomoaki Yoshikawa ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Walking Ability ◽  
Neck Fracture

scholarly journals Bilateral Simultaneous Femoral Neck Fracture Mimicking Abdominal Pain in a Cerebral Palsy Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
P. Mariani ◽  
M. Buttaro ◽  
F. Comba ◽  
E. Zanotti ◽  
P. Ali ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Abdominal Pain ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Primary Care Physicians ◽  
Walking Ability ◽  
X Rays ◽  
Permanent Disability ◽  
Neck Fracture ◽  
Cerebral Palsy Patient

Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability.

scholarly journals Effect of nutritional status before femoral neck fracture surgery on postoperative outcomes: a retrospective study

2021 ◽  
Author(s):  
Katsuya Yokoyama ◽  
Taku Ukai ◽  
Masahiko Watanabe
Keyword(s):  
Femoral Neck ◽  
Nutritional Status ◽  
Femoral Neck Fracture ◽  
Transfer Rate ◽  
Normal Group ◽  
Postoperative Outcomes ◽  
Transfusion Rate ◽  
Neck Fracture ◽  
Gait Function ◽  
Fracture Surgery

Abstract Background Although nutritional status is crucial in gait recovery after femoral neck fracture surgery, the relationship between preoperative nutritional status and postoperative outcomes remains unknown. This study examined the effects of preoperative nutritional status on postoperative outcomes in patients undergoing femoral neck fracture surgery. Methods Data regarding the joints of 137 patients (29 men, 108 women) who underwent bipolar hemiarthroplasty for femoral neck fractures at our hospital from January 2015 to December 2019 were retrospectively examined. The Geriatric Nutritional Risk Index (GNRI), an index of nutritional status, was used to classify patients into two groups: a normal group (GNRI ≥ 92; n = 62) and an undernourished group (GNRI < 92; n = 75). The study endpoints included age at surgery, sex, preoperative waiting period, intraoperative blood loss, surgery time, blood transfusion rate, complication rate, 6-month mortality rate, transfer rate, and percentage of patients unable to walk at discharge or transfer. Results The undernourished group was significantly older at surgery (83.3 ± 6.9 years versus [vs.] 79.6 ± 8.8 years; p < 0.01) and had a higher blood transfusion rate (41.3% [31/75] vs. 12.9% [8/62]; p < 0.01), a longer preoperative waiting period (5.5 ± 5.8 days vs. 3.9 ± 2.6 days; p < 0.05), a higher transfer rate (24% [18/75] vs. 9.7% [6/62]; p < 0.05), a higher complication rate (52% [39/75] vs. 35.5% [22/62]; p < 0.05), and a higher 6-month mortality rate (13.3% [10/75] vs. 0% [0/62]; p < 0.01) than the normal group. The most common complication was pneumonia. Patients in the undernourished group had worse rates of postoperative complications, transfer, and mortality than the normal group. Conclusions A poor nutritional status affects the gait function and systemic condition of patients undergoing femoral neck fracture surgery; therefore, early nutritional interventions may reduce mortality rates and shorten rehabilitation. These results suggest that the GNRI effectively predicts postoperative complications, mortality, and gait function.

Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

2008 ◽  
Vol 149 (11) ◽  
pp. 493-503 ◽  
Author(s):  
Andor Sebestyén ◽  
Imre Boncz ◽  
Ferenc Tóth ◽  
Márta Péntek ◽  
József Nyárády ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

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