Key result
Age greater than 69.5 years is the main prognostic factor for poor and fair functional outcomes following intertrochanteric fracture surgery.
Why the study?
Fracture type, surgery type, and comorbidities affect postoperative outcomes in intertrochanteric fractures, prompting evaluation of how pre- and postoperative clinical and paraclinical conditions impact functional outcomes.
What are the prognostic factors for functional outcome in patients undergoing intertrochanteric fracture surgery?
Observational (n=310)
No
What are the prognostic factors for functional outcome in patients undergoing intertrochanteric fracture surgery?
Effect estimate: AUC 0.916 (95% CI 0.871-0.961)
p-value: p=<0.001
Age >69.5 years is the primary prognostic factor for poor functional outcomes following intertrochanteric fracture surgery.
Age >69.5 years may guide risk stratification and counseling after intertrochanteric fracture surgery; observational data leaves open prospective validation and targeted interventions.
Objectives: The type of fracture, type of surgery, and patient comorbidities affect the possibility of achieving the best postoperative outcome in intertrochanteric fractures. We aim to evaluate the effect of the patient’s clinical and paraclinical condition before and after surgery on postoperative functional outcomes with the Harris hip score instrument.Design: RetrospectiveSetting: single-centerPatient/Participants: This study included 310 patients undergoing intertrochanteric fracture surgery at one center from November 2016 to September 2020.Intervention: Patient demographic, comorbidity and pre and postoperative laboratory data, complication, and Harris Hip Score data were collected.Main Outcome Measurements: Multivariate logistic regression was used to determine the effect of demographic characteristics (sex, age, type of fracture regarding AO/OTA classification, height, weight, body mass index), habitual and past medical history( hypertension, ischemic heart disease, diabetes mellitus, thyroid malfunction, cancer, osteoporosis, smoking) lab data (Complete blood cell, blood sugar, Blood Urea Nitrogen (BUN), Creatinine (Cr), Na, and K ), surgery-related factors (Anesthesia time and type, intraoperative blood transfusion, postoperative blood transfusion, and operation time), duration of admission to surgery and anticoagulant consumption after a median of 29.84 months (range: 5-69.4 months ) follow-up on Harris Hip Score of patients undergoing intertrochanteric fracture surgery.Results: When Harris Hip Score compared between following characteristics the distribution was significant: AO/OTA classification (p=0.037), sex (p=0.017), hypertension (HTN) (p=0.001), Diabetes mellitus (DM) (p=0.038), Anticoagulant consumption (p=0.01), smoke (p=0.000), osteoporosis (p=0.001), anesthesia type (p=0.003), age (p=0.000), hemoglobin (Hb) before surgery (p=0.004), height (p=0.000), BUN before surgery (p=0.010), and Δ Na (p=0.046). in multivariable regression age is the main prognostic factor and Age >69.5 is prognostic factor for poor and fair Harris Hip Score.Conclusion: To improve the functional outcomes in IT fractures, the patient-related factors (underlying disease and the use of drugs, anemia status as well as electrolytes) and fracture type should be considered. Among the all these, age remains the main prognostic factor.Level of Evidence: Prognostic Level III.
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Babagoli et al. (2022) conducted an observational in Intertrochanteric fracture (n=310). Age >69.5 years vs. Age ≤69.5 years was evaluated on Harris Hip Score (HHS) categorized as poor/fair vs good/excellent (AUC 0.916, 95% CI 0.871-0.961, p=<0.001). Age greater than 69.5 years is the main prognostic factor for poor and fair functional outcomes following intertrochanteric fracture surgery.
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