JAAOS Global Research & Reviews最新文献

Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures 踝关节骨折后钙骨密度的变化及与临床结果的相关性

JAAOS Global Research & Reviews Pub Date : 2024-05-01 DOI: 10.5435/JAAOSGlobal-D-23-00156

U. Wiebking, Michael Kohake, Padraigh F. O'Loughlin, Ralph Gaulke

{"title":"Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures","authors":"U. Wiebking, Michael Kohake, Padraigh F. O'Loughlin, Ralph Gaulke","doi":"10.5435/JAAOSGlobal-D-23-00156","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00156","url":null,"abstract":"Introduction: The study investigates the long-term bone quality and its influence on clinical results after surgical treatment of Weber B-type fractures. Methods: Surgery treated isolated Weber B-type fractures between 2006 and 2016 were included. Bone density was determined by ultrasonography densitometry of the calcaneus. American Orthopedic Foot and Ankle Society (AOFAS), Foot Function Index, Olerud-Molander-Ankle-Score, Hannover-Score, and Short Form Health Survey SF 36 were recorded. Results: Sixty patients were followed up. Mean follow-up was 6.6 years (range, 2 to 12 years). Mean bone density T-score of the treated foot was significantly lower than that of the contralateral untreated side (−0.6 versus −0.3; P = 0.05). Higher T-scores on the injured side were significantly and positively correlated with improved outcomes in the AOFAS, Olerud-Molander-Ankle-Score, and SF-36 physical component summary but negatively correlated with the Hannover score (P ≤ 0.05). A significant correlation existed only between the pain scores of the AOFAS and Foot Function Index. Controlling for potential confounding variables, such as age and smoking status, in a linear regression model, increased bone density was only associated with the AOFAS score. Discussion: A significant reduction in bone density persists for more than eight years in some individuals. Statistically significant correlation between reduced bone density and clinical outcomes was found only for the AOFAS scoring system.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"1 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Surgeon-Preferred Staff and Staff Turnover on Operating Time and Complication Rates in Reverse and Anatomic Total Shoulder Arthroplasty 外科医生首选员工和员工流动对反向和解剖全肩关节置换术手术时间和并发症发生率的影响

JAAOS Global Research & Reviews Pub Date : 2024-05-01 DOI: 10.5435/JAAOSGlobal-D-24-00104

MD Sarah C. Kurkowski, BA Samuel K. Gerak, BS Michael J. Thimmesch, BS Henry A. Kuechly, Mbe K. Schuyler Nissen, BS Adam C. Valenti, BS Rahul D. Patel, MD Brian M. Grawe, Dr. Kurkowski, Mr. Kuechly Dr, OH Mr Clifton Ave, Ms Gerak, Mr Nissen, Valenti Mr, Patel, Mr. Thimmesch, Mr Kuechly

{"title":"Effects of Surgeon-Preferred Staff and Staff Turnover on Operating Time and Complication Rates in Reverse and Anatomic Total Shoulder Arthroplasty","authors":"MD Sarah C. Kurkowski, BA Samuel K. Gerak, BS Michael J. Thimmesch, BS Henry A. Kuechly, Mbe K. Schuyler Nissen, BS Adam C. Valenti, BS Rahul D. Patel, MD Brian M. Grawe, Dr. Kurkowski, Mr. Kuechly Dr, OH Mr Clifton Ave, Ms Gerak, Mr Nissen, Valenti Mr, Patel, Mr. Thimmesch, Mr Kuechly","doi":"10.5435/JAAOSGlobal-D-24-00104","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00104","url":null,"abstract":"Background: This study focuses on investigating the risk factors of increased operating room time and patient complication rates after total shoulder arthroplasty cases (both reverse and anatomic). We hypothesize that the use of surgeon-preferred staff will improve operating room efficiency and reduce complication rates while increased staff turnover will decrease efficiency and increase complications. Methods: This is a single-center, retrospective study focused on determining the effects of staffing on operating room time and efficiency in total shoulder arthroplasty. The study included patients who underwent total shoulder arthroplasty by a single fellowship-trained orthopaedic surgeon from 2018 to 2023. Results: Four hundred twenty-three patients were included in the study from August 2018 to April 2023, 264 of which were reverse total shoulder arthroplasty (rTSA) and 159 were anatomic total shoulder arthroplasty (aTSA). In both rTSA and aTSA, the presence of surgeon-preferred staff markedly decreased operating room time. In rTSA, staff turnover increased risk of 90-day complications. Conclusion: Because the presence of surgeon-preferred staff affects operating room time and efficiency, orthopaedic surgeons should train multiple surgical teams so that efficiency is not affected by the loss of personnel during a case. To reduce 90-day complication rates in rTSA, staff breaks and turnover should be minimized as much as possible because this has a direct effect on patient outcomes. Effort from hospital administration and management should be put toward reducing turnover to improve patient outcomes.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"170 S367","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion 单层腰椎后路融合术术中预防性使用头孢唑啉与头孢唑啉联合妥布霉素或庆大霉素的比较

JAAOS Global Research & Reviews Pub Date : 2024-05-01 DOI: 10.5435/JAAOSGlobal-D-24-00082

Meera M. Dhodapkar, Seongho Jeong, Scott J. Halperin, Daniel R. Rubio, Mengnai Li, Jonathan N. Grauer

{"title":"Cefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion","authors":"Meera M. Dhodapkar, Seongho Jeong, Scott J. Halperin, Daniel R. Rubio, Mengnai Li, Jonathan N. Grauer","doi":"10.5435/JAAOSGlobal-D-24-00082","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00082","url":null,"abstract":"Introduction: Surgical site infection (SSI) is a rare but serious complication of lumbar fusion. Determining an optimal antibiotic prophylaxis regimen to minimize its incidence is critical. Methods: Adult single-level posterior lumbar fusion (PLF) patients were identified from the 2010 to October 2021 PearlDiver M157 database, excluding those with infectious, neoplastic, or traumatic diagnoses in the 90 days preoperatively or inactivity in 90 days postoperatively. Intraoperative antibiotic prophylaxis regimens were determined using the Current Procedural Terminology J-codes. Two cohorts were created: (1) patients who received cefazolin alone and (2) patients who received cefazolin and either tobramycin or gentamicin. Differences in age, sex, and Elixhauser Comorbidity Index (ECI) and 90-day postoperative adverse outcomes and 2-year revision rates were assessed with univariable analysis and multivariable logistic regression controlling for patient age, sex, and ECI. Results: Of 8,161 PLF patients, 7,562 (92.7%) received cefazolin for perioperative antibiotic prophylaxis and 599 (7.3%) received cefazolin and gentamicin/tobramycin. Antibiotic subgroups did not vary in age, sex, or ECI (P > 0.05 for all). On univariable and multivariable analyses, no 90-day outcomes, nor 2-year revision rates varied significantly between the antibiotic prophylaxis subgroups (P > 0.05 for all). Discussion: For single-level PLF, cefazolin alone versus cefazolin and gentamicin/tobramycin did not differ in rates of 90-day adverse outcomes or 2-year revisions.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"95 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center 糖尿病患者的骨折：一家一级创伤中心 20 年来的登记结果

JAAOS Global Research & Reviews Pub Date : 2024-05-01 DOI: 10.5435/JAAOSGlobal-D-23-00166

M. Hoffa, R. Furdock, Tyler J. Moon, Abigail Bacharach, Isabella M. Heimke, Heather A. Vallier

{"title":"Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center","authors":"M. Hoffa, R. Furdock, Tyler J. Moon, Abigail Bacharach, Isabella M. Heimke, Heather A. Vallier","doi":"10.5435/JAAOSGlobal-D-23-00166","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00166","url":null,"abstract":"Introduction: Diabetes mellitus (DM) is a risk factor of infection. Although DM has been associated with worse functional outcomes after acetabular fracture, literature regarding the effect of DM on surgical site infection and other early complications is lacking. Methods: A 20-year registry from a level 1 trauma center was queried to identify 134 patients with DM and 345 nondiabetic patients with acetabular fractures. Results: The diabetic patient population was older (57.2 versus 43.2; P < 0.001) and had higher average body mass index (33.6 versus 29.5; P < 0.001). Eighty-three patients with DM and 270 nondiabetics were treated surgically (62% versus 78%; P < 0.001). Diabetic patients who were younger (54.6 versus 61.4; P = 0.01) with fewer comorbidities (1.7 versus 2.2; P = 0.04) were more frequently managed surgically. On univariate analysis, patients with DM more commonly developed any early infection (28.4% versus 21%; P = 0.049) but were no more likely to develop surgical site infection, or other postoperative complications. Older patient age, length of stay, baseline pulmonary disease, and concurrent abdominal injury were independent predictors of postoperative infection other than surgical site infection. Diabetics that developed infection had more comorbidities (2.4 versus 1.5; P < 0.001) and higher Injury Severity Score (24.1 versus 15.8; P = 0.003), and were more frequently insulin-dependent (72.7% versus 41%; P = 0.01). Discussion: Independent of management strategy, diabetic patients were more likely to develop an infection after acetabular fracture. Insulin dependence was associated with postoperative infection on univariate analysis. Optimal selection of surgical candidates among patients with DM may limit postoperative infections.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demographics and Outcomes of Glenohumeral Dislocations in Individuals With Elevated Body Mass Index 体重指数升高者盂肱关节脱位的人口统计学特征和治疗结果

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-24-00021

Bhargavi Maheshwer, Penelope Halkiadakis, Jason G. Ina, B. Bafus, Adrienne Lee

{"title":"Demographics and Outcomes of Glenohumeral Dislocations in Individuals With Elevated Body Mass Index","authors":"Bhargavi Maheshwer, Penelope Halkiadakis, Jason G. Ina, B. Bafus, Adrienne Lee","doi":"10.5435/JAAOSGlobal-D-24-00021","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00021","url":null,"abstract":"Introduction: No specific study has investigated the characteristics and outcomes of anterior shoulder dislocations in morbidly obese individuals. The purpose of this study was to describe shoulder dislocations in patients with body mass index (BMI) greater than 40. Methods: A retrospective review was conducted to identify patients aged 18 years and older with a BMI ≥40 who presented with a shoulder dislocation in a single institution from 2000 to 2020. Dislocation patterns, associated injuries, treatment modalities, and associated complications were recorded. Results: A significant increase was noted in the number of patients with BMI greater than 40 presenting per year (r2 = −0.831, P < 0.01) over the past 20 years. A significant increase was noted in the average BMI per year in this population (r2 = 0.504, P = 0.028). Fifteen patients (19.5%) experienced at least one recurrent dislocation episode. Ten patients had a Bankart lesion that was associated with an elevated BMI (P = 0.04). Nine patients (11.7%) sustained an associated neurologic injury (no association with BMI). Conclusions: Over time, there has been an increase in shoulder dislocations in morbidly obese individuals in the United States, alongside an overall increase in the average BMI of patients who present with shoulder dislocations.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Relationship Between Preoperative International Normalized Ratio and Postoperative Major Bleeding in Total Shoulder Arthroplasty 全肩关节置换术术前国际标准化比率与术后大出血之间的关系

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-23-00174

Dafang Zhang, G. S. Dyer, Brandon E. Earp

{"title":"The Relationship Between Preoperative International Normalized Ratio and Postoperative Major Bleeding in Total Shoulder Arthroplasty","authors":"Dafang Zhang, G. S. Dyer, Brandon E. Earp","doi":"10.5435/JAAOSGlobal-D-23-00174","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00174","url":null,"abstract":"Introduction: This study aimed to assess the relationship between preoperative international normalized ratio (INR) levels and major postoperative bleeding events after total shoulder arthroplasty (TSA). Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TSA from 2011 to 2020. A final cohort of 2405 patients with INR within 2 days of surgery were included. Patients were stratified into four groups: INR ≤ 1.0, 1.0 < INR ≤ 1.25, 1.25< INR ≤ 1.5, and INR > 1.5. The primary outcome was bleeding requiring transfusion within 72 hours, and secondary outcome variables included complication, revision surgery, readmission, and hospital stay duration. Multivariable logistic and linear regression analyses adjusted for relevant comorbidities were done. Results: Of the 2,405 patients, 48% had INR ≤ 1.0, 44% had INR > 1.0 to 1.25, 7% had INR > 1.25 to 1.5, and 1% had INR > 1.5. In the adjusted model, 1.0 < INR ≤ 1.25 (OR 1.7, 95% CI 1.176 to 2.459), 1.25 < INR ≤ 1.5 (OR 2.508, 95% CI 1.454 to 4.325), and INR > 1.5 (OR 3.200, 95% CI 1.233 to 8.302) were associated with higher risks of bleeding compared with INR ≤ 1.0. Discussion: The risks of thromboembolism and bleeding lie along a continuum, with higher preoperative INR levels conferring higher postoperative bleeding risks after TSA. Clinicians should use a patient-centered, multidisciplinary approach to balance competing risks.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"64 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lost in the Shuffle: Low Health Literacy in Geriatric Fracture Patients and Families Regarding Post-Acute Care—A Prospective Study 在混乱中迷失：老年骨折患者及家属对急性期后护理的低健康素养--一项前瞻性研究

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-24-00062

Stephanie Merimee, Ashley Ali, Katheryne Downes, Joanna Mullins, Mir Ibrahim Sajid, Hassan Mir

{"title":"Lost in the Shuffle: Low Health Literacy in Geriatric Fracture Patients and Families Regarding Post-Acute Care—A Prospective Study","authors":"Stephanie Merimee, Ashley Ali, Katheryne Downes, Joanna Mullins, Mir Ibrahim Sajid, Hassan Mir","doi":"10.5435/JAAOSGlobal-D-24-00062","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00062","url":null,"abstract":"Introduction: This study aims to evaluate health literacy (HL) in geriatric orthopaedic trauma patients and their families as it relates to their post-acute care (PAC) in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs). Methods: This nonrandomized controlled clinical trial included patients aged 65 years and older treated for acute fracture at a Level 1 trauma center and discharged to either IRF or SNF. First 106 patients enrolled served as the control group and received standard discharge instructions. The second 101 patients were given a set of oral and written instructions regarding PAC detailing important questions to ask upon arrival to their facility. Results: The mean HL score for all patients/families was 2.4 out of 5. No significant difference was noted in HL scores (2.4 versus 2.3) or median LOS (22 versus 28 days) between the control and intervention groups. Family involvement (68%) slightly improved HL scores (2.6 versus 1.9, P < 0.001). Patients discharged to IRF had better HL scores (3.4 versus 2.3, P < 0.001), shorter LOS (median 15 vs 30 days, P < 0.001), and trended toward improved knowledge of discharge goals (48.1% versus 35.6%) than those in SNF. Conclusion: System-wide solutions are necessary to improve geriatric HL and optimize outcomes in orthopaedic trauma.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"361 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Management of Impending Skin Necrosis After a Posterolateral Knee Dislocation 成功治疗膝关节后外侧脱位后即将发生的皮肤坏死

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-23-00149

E. Santos, Christopher A. Schneble, David N. Kim, Michael J. Medvecky

引用次数: 0

Trends in Orthopaedic Surgery Workforce Diversity: Analyzing Changes Over Time 矫形外科劳动力多样性趋势：分析随时间的变化

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-24-00038

Zachary C. Lum, Stanley Dennison, Hai V. Le, Christopher O. Bayne, Cassandra A. Lee

{"title":"Trends in Orthopaedic Surgery Workforce Diversity: Analyzing Changes Over Time","authors":"Zachary C. Lum, Stanley Dennison, Hai V. Le, Christopher O. Bayne, Cassandra A. Lee","doi":"10.5435/JAAOSGlobal-D-24-00038","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00038","url":null,"abstract":"Introduction: There are many reasons why orthopaedic surgeons move or change careers. We asked the questions: (1) What is the geographic distribution of orthopaedic surgeons with respect to age, sex, and race and ethnicity? (2) How has our workforce changed over time with regard to these factors? (3) Are there any patterns or trends detected regarding policy or regulatory events that coincide with these differences? Methods: The American Academy of Orthopaedic Surgeons surveys over 30,000 members, collecting data on demographics, age, race sex, and practice statistics. We calculated geographic distributions and evaluated these differences over time—potential influences from malpractice suits or tort reform were investigated. Results: Overall surgeon density increased over time. The largest negative changes were noted in District of Columbia, Wyoming, and North Dakota and positive changes in Colorado, South Dakota, and West Virginia. Age across all states increased (mean 1.7 years). Number of female surgeons increased in most states (4.6% to 5.7%). Number of African Americans increased from 1.6% to 1.8%, Hispanic/LatinX from 1.8% to 2.2%, Asian from 5.5% to 6.7%, and multiracial from 0.8% to 1.2%. No change was noted in the percentage of Native American surgeons. Discussion: Surgeon density increased from 2012 to 2018; the cause for this change was not evident. Small increases in surgeon population, female surgeons, and in some underrepresented minorities were seen.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"35 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery 髋部骨折手术后术前血小板增多患者的疗效

JAAOS Global Research & Reviews Pub Date : 2024-04-01 DOI: 10.5435/JAAOSGlobal-D-23-00159

Christian A. Gonzalez, Noelle L. Van Rysselberghe, Clayton W. Maschhoff, Michael J. Gardner

{"title":"Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery","authors":"Christian A. Gonzalez, Noelle L. Van Rysselberghe, Clayton W. Maschhoff, Michael J. Gardner","doi":"10.5435/JAAOSGlobal-D-23-00159","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00159","url":null,"abstract":"Introduction: Low platelet counts have clinically relevant effects on patient outcomes after hip fracture surgery; however, the relationship between abnormally high platelet counts and postoperative outcomes in this population is unknown. Methods: The ACS-NSQIP database was queried for patients who underwent hip fracture surgery between 2015 and 2019. Outcomes were compared between patients with normal platelet counts (150,000 to 450,000/μL) and thrombocytosis (>450,000/μL). Results: Eighty-six thousand three hundred eleven hip fracture patients were identified, of which 1067 (1.2%) had preoperative thrombocytosis. Compared with patients with normal platelet counts, patients with preoperative thrombocytosis had increased rates of 30-day mortality (6.4% vs 4.5%, P = 0.004; OR 1.15 [95% CI 0.88 to 1.50], P = 0.322) as well as increased rates and odds of readmission (11.4% vs 7.8%, P < 0.001; OR 1.35 [95% CI 1.10 to 1.65], P = 0.004) and venous thromboembolic events (3.2% vs 1.7%, P < 0.001; OR 1.88 [95% CI 1.31 to 2.71], P < 0.001). Conclusions: Hip fracture patients with preoperative thrombocytosis had increased rates of early mortality as well as increased odds of venous thromboembolic events and readmission. A patient with thrombocytosis may benefit from close postoperative surveillance and careful follow-up. Future prospective studies are needed to verify causation and investigate how to mitigate adverse outcomes in hip fracture patients with preoperative thrombocytosis.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"101 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0