Geriatric Orthopaedic Surgery & Rehabilitation最新文献

{"title":"A Study on the Synergistic Effects of Hip Capsule Nerve and Stellate Ganglion Block on Postoperative Rehabilitation Outcomes in Elderly Patients Following Total Hip Arthroplasty.","authors":"Di Liu, Yunzhi Ling, Nannan Song, Wentao Dai, Meijun Shen, Congli Zhang","doi":"10.1177/21514593251361461","DOIUrl":"10.1177/21514593251361461","url":null,"abstract":"<p><strong>Objective: </strong>The presenting research aimed to assess the clinical results of hip pericapsular nerve group block (PENGB) combined with stellate ganglion block (SGB) on postoperative pain management and early rehabilitation in total hip arthroplasty (THA) patients.</p><p><strong>Methods: </strong>There were 50 THA cases at our hospital inluded in the study. Twenty-five patients in the experimental group received general anesthesia combined with PENGB and SGB, while the remaining 25 patients in the control group received conventional general anesthesia. Mean arterial pressure and heart rate were recorded 30 min after the start of surgery and immediately postoperatively. The Numeric Rating Scale (NRS) scores for pain at rest and during movement were recorded at baseline (T0), 30 min (T1), 6 h (T2), 24 h (T3), and 48 h (T4) after the combined block was administered. The Athens Insomnia Scale (AIS) scores were recorded for 2 consecutive days postoperatively. Additionally, the number of analgesic pump presses, the time to first mobilization, patient satisfaction scores, and postoperative complications were documented.</p><p><strong>Results: </strong>Compared with the control group, the experimental group exhibited more stable hemodynamics 30 min after the start of the operation and immediately postoperatively (<i>P</i> < 0.05). At T0, the 2 groups had no significant difference in NRS scores (<i>P</i> > 0.05). However, from T1 to T4, the experimental group had significantly lower NRS scores at rest and during movement, AIS scores for 2 consecutive days post-surgery, achieved earlier mobilization, shorter hospital stays, and reported higher overall satisfaction with hospitalization, all of which were statistically significant (<i>P</i> < 0.05). The postoperative complications rate of the 2 groups were similar (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>PENGB combined with SGB significantly enhances postoperative pain management, shortens hospital stay, and improves early rehabilitation outcomes in elderly patients undergoing total hip arthroplasty compared to conventional general anesthesia.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251361461"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Life-Space Mobility After Total Hip Arthroplasty in Females With Osteoarthritis: A Single-Center Retrospective Cohort Study.","authors":"Ryota Kuratsubo, Hiroyuki Watanabe, Masashi Nagao, Naoto Kamide, Kazuki Kaji, Naruaki Toda, Kosuke Mizuno, Hironori Kaneko, Yuji Takazawa","doi":"10.1177/21514593251360812","DOIUrl":"10.1177/21514593251360812","url":null,"abstract":"<p><strong>Background: </strong>Life-space mobility is defined as the spatial area traversed by an individual in daily life, extending from bedroom to locations beyond the individual's hometown, considering distance, frequency, and required assistance. The Life-Space Assessment (LSA) is used to evaluate life-space mobility. It has been reported that the LSA score after total hip arthroplasty (THA) shows an improvement relative to the preoperative score in patients with hip osteoarthritis. Symptoms and walking function also improve after THA. However, the association between these improvements and an increase in the LSA score after THA remains unclear. The purpose of this study was to identify the factors associated with an increase in the LSA score after THA in females with hip osteoarthritis.</p><p><strong>Methods: </strong>This retrospective cohort study involved females planning to undergo primary and unilateral THA for hip osteoarthritis. The LSA score, subjective hip symptoms and function (assessed using the modified Harris hip score), and walking speed were assessed preoperatively and at 6 months postoperatively. Factors associated with the postoperative change in the LSA score were investigated using multiple regression analysis.</p><p><strong>Results: </strong>A total of 120 participants were included. Improvement in walking speed (β = 0.19, <i>P</i> = 0.011) was significantly associated with the postoperative increase in the LSA score. The preoperative LSA score (β = -0.67, <i>P</i> < 0.001), age (β = -0.17, <i>P</i> = 0.011), and contralateral hip osteoarthritis (β = -0.15, <i>P</i> = 0.017) were also associated with the change in the LSA score.</p><p><strong>Conclusions: </strong>The recovery of maximal walking speed, preoperative life-space mobility, age, and contralateral hip osteoarthritis influenced postoperative expansion of life-space mobility. Improved walking speed may serve as a key factor contributing to the expansion of life-space mobility following THA.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251360812"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture.","authors":"Daisuke Enomoto, Hyonmin Choe, Masahiro Matsumoto, Koki Abe, Kazuyoshi Yamamoto, Kousuke Matsuo, Hiroyuki Makita, Naomi Kobayashi, Yutaka Inaba","doi":"10.1177/21514593251361803","DOIUrl":"10.1177/21514593251361803","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of proximal femoral fractures typically involves fixation with intramedullary nailing or sliding hip screws, where screws inserted into the femoral head stabilize the fracture site. However, few studies have quantitatively assessed the distribution of bone density and quality within the femoral head. We investigated the distribution of bone mineral density (BMD) within the proximal femoral head, evaluated inter-patient variability, and examined associated factors based on computed tomography (CT) values.</p><p><strong>Methods: </strong>This multicenter prospective observational study included 100 patients with femoral trochanteric fractures. Preoperative CT images were obtained from the first lumbar vertebra to the distal end of the femur. Using 3D Slicer (version 7), the proximal uninjured femur was segmented and reconstructed into a 3D model. The volume and CT values (Hounsfield units [HU]) of the proximal femur and femoral head were measured. Additionally, CT values were used to assess the bone volume and distribution of low bone-density areas (0-100 HU) and high bone-density areas (≥300 HU) in the femoral head.</p><p><strong>Results: </strong>The average bone volume and CT values of proximal femur and femoral head were 90,641 mm³ and 94 HU, and 32,316 mm³ and 131 HU, respectively. The volume of the femoral head with CT values ≥300 HU was 2967 mm³, accounting for 9.1% of the total volume (range: 0.1%-32.6%), with a distribution observed along the central region of the femoral head, particularly along the principal compressive trabeculae. Additionally, the average CT value of the femoral head (<100 HU, ≥300 HU) correlated with bone volume.</p><p><strong>Conclusion: </strong>A distribution of CT values within the femoral head is characteristic of patients with femoral trochanteric fractures. Using HU values from CT imaging to predict bone fragility preoperatively may aid in assessing the risk of postoperative complications.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251361803"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Correlations of Sarcopenia and Obesity Status with Prevalence of Osteoarthritis in Older Adults.","authors":"Yeqing Wang, Guofang Gao, Zhongxin Zhu","doi":"10.1177/21514593251360384","DOIUrl":"10.1177/21514593251360384","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis (OA) is a prevalent chronic joint disease affecting approximately 7% of the global population, with increasing significance in aging populations. Sarcopenia and obesity, two interconnected age-associated conditions, have potential pathogenic roles in OA development, yet their precise interactions remain incompletely understood.</p><p><strong>Material and methods: </strong>A cross-sectional analysis was conducted using National Health and Nutrition Examination Survey (NHANES) data from 1999-2006, focusing on 2309 participants aged 65 years and older. Sarcopenia and obesity were assessed via dual-energy X-ray absorptiometry-derived body composition measures, and OA status was determined through self-reported physician diagnoses. Multiple logistic regression models were employed to investigate the correlations between sarcopenia, obesity status, and the prevalence of OA.</p><p><strong>Results: </strong>Sarcopenia was positively associated with OA, with an adjusted OR of 1.38 (95% CI: 1.07-1.79). Obesity demonstrated a consistent positive correlation with OA (adjusted OR: 1.31, 95% CI: 1.03-1.65). Subgroup analyses revealed nuanced associations, particularly among specific demographic groups such as non-Hispanic Black individuals and those with comorbidities like hypertension and diabetes.</p><p><strong>Conclusions: </strong>The study reveals complex interrelationships between sarcopenia, obesity, and OA prevalence in older adults. The findings underscore the importance of body composition in joint health and suggest the need for targeted interventions considering demographic and clinical variations.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251360384"},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery.","authors":"Ruqayyah Turabi, Frede Frihagen, Rhona McGlasson, David Wyatt, Alex Trompeter, Lauren Beaupre, Luiz Fernando Cocco, Matthew Costa, José Luis Dinamarca-Montecinos, Juan Carlos Viveros-García, Jae-Young Lim, Joon-Kiong Lee, Hui Min Khor, Cristina Ojeda-Thies, Monica Perracini, Takeshi Sawaguchi, Julie Switzer, Irewin Tabu, Ronald Man Yeung Wong, Wei Mao, Katie Jane Sheehan","doi":"10.1177/21514593251351136","DOIUrl":"10.1177/21514593251351136","url":null,"abstract":"<p><strong>Objectives: </strong>This position paper from the Fragility Fracture Network (FFN) responds to the observed global variation in weight-bearing prescriptions after hip fracture surgery in older adults.</p><p><strong>Methods: </strong>The paper summarises current guidelines and evidence regarding unrestricted weight-bearing after hip fracture surgery.</p><p><strong>Results: </strong>The synthesis of available evidence supports the endorsement of unrestricted weight-bearing after surgery to enhance patient outcomes.</p><p><strong>Conclusion: </strong>The FFN endorses unrestricted weight-bearing and recommends healthcare professionals, institutions, and policymakers re-evaluate practices favouring limited or non-weight-bearing prescriptions and establish a standardised system for monitoring and auditing, with clear justification and documentation of any restrictions.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251351136"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms and Osteoporosis in Middle-Aged and Older Adults: A Cross-Sectional Analysis of NHANES and HRS Data.","authors":"Wen Zhang, Yi Tang, Lei Chen, Zhongyi Zhang, Xinyu Hu, Kai Cheng, Jiaju Zhou, Peijian Tong","doi":"10.1177/21514593251357525","DOIUrl":"10.1177/21514593251357525","url":null,"abstract":"<p><strong>Background & aims: </strong>Depression and osteoporosis are common among middle-aged and older adults, both impacting morbidity and quality of life. Their shared risk factors suggest a potential link, but this relationship remains underexplored. This study aimed to assess the association between depressive symptoms and osteoporosis in two large cohorts: the National Health and Nutrition Examination Survey (NHANES, 2005-2010) and Health and Retirement Study (HRS, 2012).</p><p><strong>Methods: </strong>We analyzed data from adults aged ≥50 years in NHANES (n = 3612) and HRS (n = 4307). Depressive symptoms were measured using PHQ-9 in NHANES and CES-D 8 in HRS, while osteoporosis was defined by self-reported diagnosis and medication use. Generalized linear models were used to evaluate the association, adjusting for demographic, lifestyle, and comorbidity factors. Subgroup analyses and sensitivity tests were conducted to explore effect modifiers and result robustness.</p><p><strong>Results: </strong>Depressive symptoms were positively associated with osteoporosis in both cohorts (NHANES: adjusted OR = 1.061, 95% CI: 1.034-1.088; HRS: adjusted OR = 1.063, 95% CI: 1.014-1.115). Significant associations were observed across subgroups, with stronger effects in individuals with diabetes and arthritis. Sex differences showed higher odds ratios for men in HRS. The relationship exhibited a linear trend, with increasing risk as depressive severity intensified.</p><p><strong>Conclusion: </strong>Depressive symptoms (PHQ-9/CES-D8) significantly associate with higher osteoporosis risk in older adults, with consistent cross-sectional findings across populations. While causality remains unclear, results support clinical bone density monitoring in depression care and depression screening in osteoporosis management. Future longitudinal studies should clarify mechanisms, while public health strategies should integrate mental-bone health prevention approaches.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251357525"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Anesthesia for Hip Fracture Surgery in Older Adults: A Retrospective Comparison of Outcomes Using ACS NSQIP Data.","authors":"Arissa M Torrie, Gerard P Slobogean, Rachel Johnson, Ron E Samet, Samuel M Galvagno, Robert V O'Toole, Nathan N O'Hara","doi":"10.1177/21514593251353114","DOIUrl":"10.1177/21514593251353114","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical fixation of hip fractures in older adults is associated with significant morbidity and mortality. We investigated whether regional anesthesia, which excluded epidural, spinal, or combined epidural-spinal, was associated with lower postoperative complication rates compared to general or spinal anesthesia in patients aged 50 years and older undergoing hip fracture surgery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Targeted Hip Fracture dataset from January 1, 2016, to December 31, 2022. Propensity score matching was used to compare regional anesthesia with general and spinal anesthesia. Given the NSQIP database excludes epidural, spinal, and combined epidural-spinal anesthesia from the regional classification, it was presumed that the remaining regional anesthesia patients received a peripheral nerve block. The primary outcome measure was a 30-day composite of death, myocardial infarction, or stroke.</p><p><strong>Results: </strong>The study analyzed 54,623 patients, from which 323 received regional anesthesia. These were separately matched with 323 cases of general anesthesia and 323 cases of spinal anesthesia. Regional anesthesia was associated with a lower incidence of the primary composite outcome compared to both general anesthesia (3% vs 7%, risk ratio 0.3, 95% CI: 0.2 to 0.6, <i>P</i> < 0.001) and spinal anesthesia (3% vs 7%, risk ratio 0.5, 95% CI: 0.3 to 0.9, <i>P</i> = 0.01). A subgroup effect was detected, with high-risk patients (ASA IV-V) experiencing the greatest protective benefit from regional anesthesia.</p><p><strong>Conclusions: </strong>Regional anesthesia techniques, excluding epidural, spinal, or combined epidural-spinal techniques, were associated with lower rates of major postoperative complications in older adults undergoing hip fracture surgery compared to general or spinal anesthesia. This benefit was more pronounced in high-risk patients. Our findings suggest that regional anesthesia, most likely administered via a peripheral nerve block, may offer benefits beyond pain control in this population, potentially improving postoperative outcomes.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251353114"},"PeriodicalIF":1.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Radius Fractures as a Call to Action: Reducing Subsequent Fragility Fracture Risk Through Early Osteoporosis Therapy.","authors":"Chenée Armando, Edward J Fox, Kenneth F Taylor","doi":"10.1177/21514593251351180","DOIUrl":"10.1177/21514593251351180","url":null,"abstract":"<p><strong>Purpose: </strong>Distal radius fractures (DRF) often serve as the initial indication of bone mineral disease. This study aims to determine the extent to which the risk of subsequent fragility fractures can be reduced by initiating anti-osteoporotic therapy after initial presentation of a DRF.</p><p><strong>Methods: </strong>This study utilized TriNetX, an online database with de-identified patient data from 79 US healthcare organizations. Females above the age of 50 were categorized based on receiving initial anti-osteoporotic treatment within a year of the DRF. Group characteristics, antiosteoporosis medications, and bone density evaluations were analyzed. After propensity matching, the risk of subsequent DRF, hip and vertebral fractures, as well as incidence of additional DEXA scans from 2004 to 2024 was explored.</p><p><strong>Results: </strong>The Medication (M) group (n = 6709) had a mean age of 69, the No Medication (NM) group (n = 181,065) had a mean age of 65 at the index incidence. Baseline differences included higher rates of bone density disorders, inflammatory polyarthropathies, spondylopathies, metabolic disorders, obesity, malnutrition, and neoplasm in the M group. Notably, 43% of the M group had a prior DEXA scan compared to 8.7% of the NM group. The most prescribed anti-osteoporotic medication in the M group was Alendronate (49%). After propensity matching (n = 6627), the M group had 32% more DEXA scans and were 25% less likely to have a subsequent DRF fracture compared to the NM group. There was no difference between groups in combined intertrochanteric and femoral neck fractures. Vertebral compression fractures demonstrated a small but statistically significant increase in the M group, with an absolute risk difference of 0.8% (number needed to treat = 125) and an effect size (Cohen's h = 0.079), suggesting limited clinical relevance.</p><p><strong>Conclusions: </strong>Timely assessment and medical intervention can prevent future DRF. However, post-DRF bone density evaluations remain infrequent. This study highlights the hand surgeon's role in identifying osteoporosis. Level of Evidence: Level III Cohort Study.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251351180"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30-day Mortality Following Revision of Hip Arthroplasty, A Cohort Study Based on the Swedish Perioperative Registry 2017-2022.","authors":"Arvid Ekeberg, Johanna Albert, Olof Sköldenberg, Jon Karlsson, Jan G Jakobsson","doi":"10.1177/21514593251355915","DOIUrl":"10.1177/21514593251355915","url":null,"abstract":"<p><strong>Introduction: </strong>In Sweden approximately 9% of hip-arthroplasty require a revision. All-cause 30-day mortality following hip revisions in Sweden is unknown.</p><p><strong>Aim: </strong>To assess all-cause 30-days mortality among hip-revision in Sweden and whether mortality has changed 2017-2022 based on data from the Swedish perioperative register (SPOR) adjusted for sex, age, ASA-class, indication and fixation technique.</p><p><strong>Method: </strong>This observational cohort study includes all hip revisions registered in SPOR between 2017 - June 2022 analysing 30-day postoperative mortality rates. Inclusion criteria: age >18 having had a hip arthroplasty revision ICD-10-SE codes NFC. Binary-logistic-regressions estimated odds-ratio (OR) for 30-days mortality over the study period, adjusted for sex, age, ASA-class, indication and fixation technique.</p><p><strong>Result: </strong>6937 patients were included in the analysis, 3333 females and 3063 males mean-age 73 years with an overall 30-day mortality rate of 1.3%. No significant differences in 30-day mortality were found over the study-period. There was no death within 30-days among patients below 65 years and within ASA-class I. Males had a mortality rate of 1.4% vs females 1.1% (ns.). Adjusted OR was significantly higher for patients with age >80 years OR 9.1 (<i>P</i> < 0.001), AS-classes III OR 3.9 and IV 14.9 (<i>P</i> < 0.001) infection 3.4 and fracture 9.1 (<i>P</i> < 0.001) but fixation technique had not.</p><p><strong>Conclusion: </strong>The all-cause 30-day mortality in Sweden was 1.3% with minor differences over the study period and between sexes, while high age especially above 80 and ASA-classes III and IV significantly increased the adjusted OR for 30-day mortality. Efforts to further optimize the perioperative care of this patient group are of importance.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251355915"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the ACS-NSQIP Risk Calculator, Nottingham Hip Fracture Score and CRP/Albumin Ratio in Predicting Adverse Postoperative Outcomes in the Hip Fracture Surgery: A Lithuanian Single-Centre Prospective Study.","authors":"Povilas Masionis, Rokas Bobina, Simonas Utkus, Raminta Martinaitytė, Valentinas Uvarovas, Igoris Šatkauskas","doi":"10.1177/21514593251352336","DOIUrl":"10.1177/21514593251352336","url":null,"abstract":"<p><p><b>Objective:</b> As the global population ages, hip fracture importance will increase. The high postoperative mortality and morbidity necessitate tools for accurate risk assessment to aid surgical decisions and inform patients and families. This study aimed to compare and validate ACS NSQIP, Nottingham hip fracture risk calculators, and C reactive protein/albumin ratio in predicting complications and 30 day mortality. <b>Methods:</b> 583 patients over the 65 years old who sustained hip fracture from simple fall and underwent surgical treatment for hip fracture were included in prospective study. Each patient was evaluated by ACS NSQIP and Nottingham hip fracture risk calculators and C reactive protein/albumin ratio was calculated from preoperative values. Patients were followed up for 30 days and all the complications were recorded. <b>Results:</b> ACS NSQIP and Nottingham hip fracture score showed AUC of .724 and .731 respectively. C reactive protein/albumin ratio performed less and showed AUC of .623 that is defined as poor predictor for 30 day mortality. Furthermore, in terms of predicting any complication, ACS NSQIP showed AUC of .645, Nottingham hip fracture score of .611 and C reactive protein/albumin ratio of .594. Nottingham hip fracture score than compared to ACS NSQIP yielded lower average of mortality rates (5.4% compared to 7.9%) in contrast of study findings of 8.1%. None of the ACS NSQIP scale predictive complication showed acceptable performance. When adjusted for fracture type, Nottingham hip fracture score showed .858 AUC in predicting 30 day mortality in femoral neck fractures. <b>Conclusions:</b> We recommend Nottingham fracture risk calculator use for 30 day mortality risk assessment in femoral neck fractures. In hip fractures combined-none of models showed strong discrimination. In our cohort C reactive protein/albumin ratio showed poor prognostic values in terms of mortality and complications.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"16 ","pages":"21514593251352336"},"PeriodicalIF":1.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}