El Khassawna Thaqif, Knapp Gero, Scheibler Nadja, Malhan Deeksha, Walter Nike, Biehl Christoph, Alt Volker, Heiss Christian, Rupp Markus
Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, 35392 Giessen, Germany.
Department of Trauma, Hand and Reconstructive Surgery, University Hospital, 35390 Giessen, Germany.
J Clin Med. 2021 Sep 23;10(19):4324. doi: 10.3390/jcm10194324.
Periprosthetic femoral fracture (PFF) is a devastating complication. Here, the authors aimed to determine the influence of the timing of surgery as a risk factor for mortality and poor postoperative outcome in patients suffering from PFF. A retrospective descriptive analysis of patients treated for PFF between January 2010 and March 2018 was performed. In addition to patient and treatment characteristics, we assessed mortality rates and postoperative functional outcome by using the Harris Hip and WOMAC score. One-year mortality after PFF was 10.7%. Delayed surgery after 48 h did not negatively influence mortality after PFF. The postoperative hospital stay did not influence the mortality rate, nor did it correlate with medical scores of comorbidities, general health or functionalities. Cementation of stem correlated negatively with the WOMAC score. Deceased patients had a higher Charlson Comorbidity Index (CCI) score, while American society of Anaesthesiologists (ASA) scores did not show a significant difference. There were no differences between ORIF and revision arthroplasty. In conclusion, delayed surgery after 48 h does not negatively influence mortality after PFF. The CCI seems to be a suitable tool to assess patients' risk for increased mortality after PFF, while the usually used ASA score is not able to achieve a relevant risk assessment.
人工关节周围股骨骨折（PFF）是一种严重的并发症。在此，作者旨在确定手术时机作为PFF患者死亡率和术后不良结局的危险因素所产生的影响。对2010年1月至2018年3月期间接受PFF治疗的患者进行了回顾性描述性分析。除了患者和治疗特征外，我们还使用Harris髋关节评分和WOMAC评分评估了死亡率和术后功能结局。PFF后1年死亡率为10.7%。48小时后延迟手术对PFF后的死亡率没有负面影响。术后住院时间对死亡率没有影响，也与合并症、总体健康状况或功能的医学评分无关。柄的骨水泥固定与WOMAC评分呈负相关。死亡患者的Charlson合并症指数（CCI）得分较高，而美国麻醉医师协会（ASA）评分没有显著差异。切开复位内固定术（ORIF）和翻修关节成形术之间没有差异。总之，48小时后延迟手术对PFF后的死亡率没有负面影响。CCI似乎是评估PFF后患者死亡率增加风险的合适工具，而通常使用的ASA评分无法进行相关的风险评估。
