Age and “general health”—beside fracture classification—affect the therapeutic decision for geriatric pelvic ring fractures: a German pelvic injury register study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-04

AUTHORS

Andreas Höch, Philipp Pieroh, Florian Gras, Tim Hohmann, Sven Märdian, Francis Holmenschlager, Holger Keil, Hans-Georg Palm, Steven C. Herath, Christoph Josten, Hagen Schmal, Fabian M. Stuby

ABSTRACT

PurposePelvic ring fractures in the elderly gain increasing importance. Nonetheless, data on factors influencing treatment decision in relation to fracture classification, age, and the resulting treatment are still rare.MethodsProspectively collected data of the German Pelvic Injury Registry from patients aged over 65 years with a pelvic ring fracture were evaluated retrospectively. Acetabular fractures, as well as type A1 and A3 fractures, were excluded. The variables age, injury pattern, type of treatment, the reason for conservative treatment, and Orthopaedic Trauma Association (OTA)/Tile classification were analyzed. Furthermore, the fracture distribution was examined after dividing patients into six age groups.ResultsA total of 1814 patients with a mean age of 80.7 ± 7.6 years, predominantly female (79.0%), were available for evaluation. The majority of patients suffered from isolated pelvic ring fractures (70.1%) and 8.2% were severely injured (ISS > 16). The most common fracture types were type A2 (35.4%), type B2 (38.0%), and type C1 (7.3%). Especially pelvic ring fractures of type A2 (96.9%) and type B2 (83.0%) were treated conservatively (overall 76.9%). Fracture instability according to the OTA/Tile classification increased the probability for an operative treatment (generalized odds ratio [OR] 6.90 [5.62; 8.52]). In contrary, increasing age independent of the fracture pattern decreased this probability (OR 0.47 [0.41–0.53]). With increasing fracture instability, general health conditions were up to 50% of the reasons for conservative treatment.ConclusionThe results of the present study underline the importance of the factors age and general health besides fracture classification for therapeutic decision-making in the treatment of pelvic ring fractures in the elderly. More... »

PAGES

2629-2636

Journal

TITLE

International Orthopaedics

ISSUE

11

VOLUME

43

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00264-019-04326-w

DOI

http://dx.doi.org/10.1007/s00264-019-04326-w

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113185173

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30949757


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28 schema:description PurposePelvic ring fractures in the elderly gain increasing importance. Nonetheless, data on factors influencing treatment decision in relation to fracture classification, age, and the resulting treatment are still rare.MethodsProspectively collected data of the German Pelvic Injury Registry from patients aged over 65 years with a pelvic ring fracture were evaluated retrospectively. Acetabular fractures, as well as type A1 and A3 fractures, were excluded. The variables age, injury pattern, type of treatment, the reason for conservative treatment, and Orthopaedic Trauma Association (OTA)/Tile classification were analyzed. Furthermore, the fracture distribution was examined after dividing patients into six age groups.ResultsA total of 1814 patients with a mean age of 80.7 ± 7.6 years, predominantly female (79.0%), were available for evaluation. The majority of patients suffered from isolated pelvic ring fractures (70.1%) and 8.2% were severely injured (ISS > 16). The most common fracture types were type A2 (35.4%), type B2 (38.0%), and type C1 (7.3%). Especially pelvic ring fractures of type A2 (96.9%) and type B2 (83.0%) were treated conservatively (overall 76.9%). Fracture instability according to the OTA/Tile classification increased the probability for an operative treatment (generalized odds ratio [OR] 6.90 [5.62; 8.52]). In contrary, increasing age independent of the fracture pattern decreased this probability (OR 0.47 [0.41–0.53]). With increasing fracture instability, general health conditions were up to 50% of the reasons for conservative treatment.ConclusionThe results of the present study underline the importance of the factors age and general health besides fracture classification for therapeutic decision-making in the treatment of pelvic ring fractures in the elderly.
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35 A2
36 A3 fractures
37 B2
38 C1
39 Injury Registry
40 MethodsProspectively
41 Orthopaedic Trauma Association
42 ResultsA total
43 Tile classification
44 Trauma Association
45 acetabular fractures
46 age
47 age groups
48 association
49 classification
50 common fracture type
51 conditions
52 conservative treatment
53 data
54 decisions
55 distribution
56 evaluation
57 factors
58 factors age
59 fracture classification
60 fracture distribution
61 fracture instability
62 fracture patterns
63 fracture type
64 fractures
65 gain
66 general health
67 general health condition
68 group
69 health
70 health conditions
71 importance
72 injury patterns
73 instability
74 isolated pelvic ring fractures
75 majority
76 majority of patients
77 mean age
78 operative treatment
79 patients
80 patterns
81 pelvic ring fractures
82 present study underlines
83 probability
84 reasons
85 register study
86 registry
87 relation
88 results
89 ring fractures
90 study
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92 therapeutic decisions
93 total
94 treatment
95 treatment decisions
96 type A1
97 type A2
98 type B2
99 type C1
100 type of treatment
101 types
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103 variables age
104 years
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