MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis
Abstract. Objective:. We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10. Design:. This was a retrospective database review. Setting:....
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-12-01
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| Series: | OTA International |
| Online Access: | http://journals.lww.com/10.1097/OI9.0000000000000289 |
| _version_ | 1797646801517412352 |
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| author | Brendan Y. Shi, MD Alexander Upfill-Brown, MD MSc Alan Li, BS Shannon Y. Wu, BS Seth Ahlquist, MD Christopher M. Hart, MD Thomas J. Kremen, MD Christopher Lee, MD Alexandra I. Stavrakis, MD |
| author_facet | Brendan Y. Shi, MD Alexander Upfill-Brown, MD MSc Alan Li, BS Shannon Y. Wu, BS Seth Ahlquist, MD Christopher M. Hart, MD Thomas J. Kremen, MD Christopher Lee, MD Alexandra I. Stavrakis, MD |
| author_sort | Brendan Y. Shi, MD |
| collection | DOAJ |
| description | Abstract. Objective:. We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10.
Design:. This was a retrospective database review.
Setting:. All centers participating in the American College of Surgeons National Surgical Quality Improvement Program database were included.
Patients/Participants:. Patients with proximal humerus fractures who (1) underwent ORIF, HA, or SA and (2) had calculable MELD scores were included.
Intervention:. Open reduction and internal fixation, hemiarthroplasty, or shoulder arthroplasty was used for treatment.
Main outcome measurements:. Thirty-day complications, mortality, readmission, and reoperation rates were measured.
Results:. Of the total 1732 PHF patients identified, 300 had a MELD score higher than 10. After propensity matching by significant covariates, MELD score higher than 10 was found to be significantly associated with higher rates of 30-day mortality, 30-day readmission, transfusion within 72 hours, and systemic complications. Among patients with a MELD score higher than 10, treatment with SA or HA instead of ORIF was associated with a higher rate of transfusion and longer operative time. There were no significant differences between treatment cohorts regarding mortality, reoperation, readmission, or complications.
Conclusions:. A MELD score higher than 10 is associated with higher risk of surgical complications, transfusion, and death in patients undergoing surgery for proximal humerus fractures. Among patients with a MELD score higher than 10, ORIF was associated with a lower transfusion rate and shorter operative time than arthroplasty or hemiarthroplasty.
Level of Evidence:. Prognostic Level III. |
| first_indexed | 2024-03-11T15:07:03Z |
| format | Article |
| id | doaj.art-ab250b06fe0e458ab721783139a32a9e |
| institution | Directory Open Access Journal |
| issn | 2574-2167 |
| language | English |
| last_indexed | 2024-03-11T15:07:03Z |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | OTA International |
| spelling | doaj.art-ab250b06fe0e458ab721783139a32a9e2023-10-30T03:46:04ZengWolters KluwerOTA International2574-21672023-12-016410.1097/OI9.0000000000000289OI90000000000000289MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysisBrendan Y. Shi, MD0Alexander Upfill-Brown, MD MSc1Alan Li, BS2Shannon Y. Wu, BS3Seth Ahlquist, MD4Christopher M. Hart, MD5Thomas J. Kremen, MD6Christopher Lee, MD7Alexandra I. Stavrakis, MD8a Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAb David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CAb David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAa Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CAAbstract. Objective:. We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10. Design:. This was a retrospective database review. Setting:. All centers participating in the American College of Surgeons National Surgical Quality Improvement Program database were included. Patients/Participants:. Patients with proximal humerus fractures who (1) underwent ORIF, HA, or SA and (2) had calculable MELD scores were included. Intervention:. Open reduction and internal fixation, hemiarthroplasty, or shoulder arthroplasty was used for treatment. Main outcome measurements:. Thirty-day complications, mortality, readmission, and reoperation rates were measured. Results:. Of the total 1732 PHF patients identified, 300 had a MELD score higher than 10. After propensity matching by significant covariates, MELD score higher than 10 was found to be significantly associated with higher rates of 30-day mortality, 30-day readmission, transfusion within 72 hours, and systemic complications. Among patients with a MELD score higher than 10, treatment with SA or HA instead of ORIF was associated with a higher rate of transfusion and longer operative time. There were no significant differences between treatment cohorts regarding mortality, reoperation, readmission, or complications. Conclusions:. A MELD score higher than 10 is associated with higher risk of surgical complications, transfusion, and death in patients undergoing surgery for proximal humerus fractures. Among patients with a MELD score higher than 10, ORIF was associated with a lower transfusion rate and shorter operative time than arthroplasty or hemiarthroplasty. Level of Evidence:. Prognostic Level III.http://journals.lww.com/10.1097/OI9.0000000000000289 |
| spellingShingle | Brendan Y. Shi, MD Alexander Upfill-Brown, MD MSc Alan Li, BS Shannon Y. Wu, BS Seth Ahlquist, MD Christopher M. Hart, MD Thomas J. Kremen, MD Christopher Lee, MD Alexandra I. Stavrakis, MD MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis OTA International |
| title | MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis |
| title_full | MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis |
| title_fullStr | MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis |
| title_full_unstemmed | MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis |
| title_short | MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis |
| title_sort | meld score predicts short term outcomes after surgical management of proximal humerus fractures a matched analysis |
| url | http://journals.lww.com/10.1097/OI9.0000000000000289 |
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