肱骨近端骨折：国家治疗趋势与相关的30天和90天再入院率

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-08-25 DOI:10.1016/j.injury.2025.112690

Tej Joshi , Daniel Calem , Daniella Ogilvie , Tuckerman Jones , Akhil Katakam , Suleiman Y Sudah , Eitan M Kohan , Frank G Alberta

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引用次数: 0

摘要

背景：随着逆行全肩关节置换术（rTSA）的使用越来越多，肱骨近端骨折的发生率正在上升。本研究分析了治疗趋势、再入院率和再入院原因。方法使用ICD-10代码查询美国全国再入院数据库（NRD）中首次诊断为肱骨近端骨折的入院患者（2016-2021）。分析患者人口统计学、合并症、设施特征和30 /90天再入院率。治疗包括非手术（Non-Op），半关节置换术（HA），解剖全肩关节置换术（aTSA）， rTSA，切开复位内固定（ORIF）和髓内钉（IMN）。结果218425例入院患者中，rTSA使用率上升（20.27% ~ 22.30%），ORIF使用率下降（20.77% ~ 14.86%）。即使在调整了年龄/合并症后，非手术患者在30天和31-90天的再入院率最高（10.5%和8.9%）。rTSA的再入院率最低（5.9%和4.6%），不稳定是最常见的原因。结论rTSA在肱骨近端骨折治疗中的应用有增加的趋势。rTSA后的再入院率是所有治疗方式中最低的，包括非手术治疗。证据水平：III级回顾性队列比较使用大数据库预后研究

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Proximal humerus fractures: national treatment trends with associated 30- and 90-day readmission rates

Background

The incidence of proximal humerus fractures is rising, with increasing use of reverse total shoulder arthroplasty (rTSA). This study analyzed treatment trends, readmission rates, and causes of readmission.

Methods

The Nationwide Readmissions Database (NRD) was queried for admissions with a primary diagnosis of proximal humerus fracture in the U.S. (2016–2021) using ICD-10 codes. Patient demographics, comorbidities, facility characteristics, and 30-/90-day readmission rates were analyzed. Treatments included non-operative (Non-Op), hemiarthroplasty (HA), anatomic total shoulder arthroplasty (aTSA), rTSA, open reduction internal fixation (ORIF), and intramedullary nailing (IMN).

Results

Among 218,425 admissions, rTSA use increased (20.27 % to 22.30 %), while ORIF decreased (20.77 % to 14.86 %). Non-Op had the highest readmission rates at 30- and 31–90 days (10.5 % and 8.9 %), even after adjusting for age/comorbidities. rTSA had the lowest readmission rates (5.9 % and 4.6 %), with instability being the most common cause.

Conclusion

There is a trend towards increased rTSA utilization for treating proximal humerus fractures. The readmission rate following rTSA was the lowest of all treatment modalities, including non-operative management.

Level of evidence

Level III Retrospective Cohort Comparison Using Large Database Prognosis Study

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.