The surgical treatment of proximal humeral fractures in elderly patients—an analysis of the long-term course of locked plate fixation and reverse total shoulder arthroplasty based on health insurance data

Author(s):  
Josef Stolberg-Stolberg ◽  
Jeanette Köppe ◽  
Robert Rischen ◽  
Moritz Freistühler ◽  
Andreas Faldum ◽  
...  
2017 ◽  
Vol 31 (4) ◽  
pp. 580-594 ◽  
Author(s):  
Paul Gellert ◽  
Petra von Berenberg ◽  
Thomas Zahn ◽  
Julia Neuwirth ◽  
Adelheid Kuhlmey ◽  
...  

Objectives: Multimorbidity in centenarians is common; although investigations of the prevalence of morbidity in centenarians are accumulating, research on profiles of co-occurrence of morbidities is still sparse. Our aim was to explore profiles of comorbidities in centenarians. Method: Health insurance data from 1,121 centenarians comprising inpatient and outpatient diagnoses from the past 5 years (2009-2013) were analyzed using latent class analysis with adjustments for sex, age, hospitalization, and long-term care. Results: Four distinct comorbidity profiles emerged from the data: 36% of centenarians were categorized as “age-associated”; 18% had a variety of comorbidities but were not diabetic were labeled “multimorbid without diabetes”; 9% were labeled “multimorbid with diabetes”; and 36% “low morbidity.” Conclusion: Patterns of comorbidities describe the complexity of geriatric multimorbidity more appropriately than an approach focused on a single disease. The profiles described by this specific research may inform clinicians and health care planners for the oldest old.


2018 ◽  
Vol 9 ◽  
pp. 215145931879524 ◽  
Author(s):  
Dani Rotman ◽  
Ornit Giladi ◽  
Adi Berliner Senderey ◽  
Alison Dallich ◽  
Oleg Dolkart ◽  
...  

Introduction: Proximal humerus fractures (PHFs) are a common fragility fracture and have been shown to increase mortality in elderly patients. In the last decade, reverse total shoulder arthroplasty (RTSA) was introduced as a reliable operative treatment option for this indication. In other fragility fractures, most notably hip fractures, urgent surgical treatment can reduce mortality. The purpose of this study is to evaluate whether treatment with RTSA can reduce 1-year mortality in elderly patients with complex displaced PHFs. Materials and Methods: A retrospective study was performed to compare 1-year mortality between 2 groups of elderly patients (>75 years old) who presented to a level 1 trauma center emergency department with complex displaced PHFs. The conservative treatment group (n = 83; mean age, 83.7 years) presented from 2008 to 2010 when RTSA was not yet available, and treatment was nonoperative. The surgical treatment group (n = 62; mean age, 82.2 years) presented from 2012 to 2015 and underwent RTSA. Results: One-year mortality was 8.1% (male 7.1%; female 8.3%) in the surgical treatment group and 10.8% (male 18.8%; female 9.0%) in the conservative treatment group. The reduction in mortality in the surgical treatment group was not significant (entire cohort P = .56; males P = .35; females P = .59). Discussion: Recent studies failed to show better functional results after surgical treatment with RTSA when compared to conservative treatment. This study suggests that a benefit of surgical treatment with RTSA that was not examined until now might exist—a reduction in the increased mortality risk associated with PHFs. Conclusions: There was no significant difference in 1-year mortality between the groups, although there was a trend showing lower mortality with RTSA, mostly in men. Further studies with larger populations and longer follow-up times are needed to determine whether this trend is of clinical significance.


2020 ◽  
Vol 19 (3) ◽  
pp. 268-277
Author(s):  
YoonDeok Han ◽  
◽  
Sunghyeon Jung ◽  
Kwang-tae Ha ◽  
Seung-Mi Kwon ◽  
...  

2016 ◽  
Author(s):  
César L. C. Mattos ◽  
Amauri H. Souza Júnior ◽  
Ajalmar R. Rocha Neto ◽  
Guilherme A. Barreto ◽  
Ronaldo F. Ramos ◽  
...  

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