The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria
Abstract Objective The aim of this study was to investigate the relationship between the Chang reduction quality criteria (CRQC) and the outcome of intertrochanteric fractures in older adults according to follow-up time. Methods This was a retrospective analysis of 389 older adult patients with inte...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-03641-z |
| _version_ | 1811311061956034560 |
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| author | Miao He Jian Liu Xu Deng Xiaoxing Zhang |
| author_facet | Miao He Jian Liu Xu Deng Xiaoxing Zhang |
| author_sort | Miao He |
| collection | DOAJ |
| description | Abstract Objective The aim of this study was to investigate the relationship between the Chang reduction quality criteria (CRQC) and the outcome of intertrochanteric fractures in older adults according to follow-up time. Methods This was a retrospective analysis of 389 older adult patients with intertrochanteric fractures treated surgically from January 2019 to June 2021, including 130 males and 259 females aged 84.6 (77.5–89.7) years. Patient survival was determined by telephone as the time between admission to hospital for fracture and death or until the study deadline (June 1, 2022). According to the CRQC, the patients were divided into the Poor, Acceptable, and Excellent groups. Univariate and multivariate Cox proportional hazard models were used to assess the association between CRQC and all-cause mortality in older adult intertrochanteric fractures at 1 year and the total follow-up time. Further subgroup analysis was performed according to different clinical and biological characteristics to improve the accuracy of the results. Results The mortality rates were 24.7% and 15.4% at 1 year and the total follow-up time, respectively. Both at one year and the total follow-up time, the mortality of the CRQC-Excellent group was significantly lower than that of the CRQC-Acceptable group (p.adj < 0.05) and the CRQC-Poor group (p.adj < 0.05). After multifactor adjustment, CRQC grades of Acceptable and Poor were independent risk factors affecting the overall and 1-year mortality. In addition, advanced age, ≥ 1 comorbidities, ASA 3 + 4, and prolonged preoperative waiting time were independent risk factors for survival at the total follow-up time. At 1 year, only ASA 3 + 4 and prolonged preoperative waiting time were independent risk factors for survival. Subgroup analysis according to different characteristics at the total follow-up time and at one year showed that in most subgroups, a decrease in the CRQC grade was significantly associated with an increase in all-cause mortality (p for trend < 0.05). Conclusions This study highlights that CRQC grades of Acceptable and Poor are associated with increased all-cause mortality in older adult intertrochanteric fractures. We should attempt to achieve good reduction of these fractures. |
| first_indexed | 2024-04-13T10:11:13Z |
| format | Article |
| id | doaj.art-d73baa267d984d5d884bc91b5fb0f403 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-13T10:11:13Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-d73baa267d984d5d884bc91b5fb0f4032022-12-22T02:50:55ZengBMCBMC Geriatrics1471-23182022-12-0122111010.1186/s12877-022-03641-zThe postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteriaMiao He0Jian Liu1Xu Deng2Xiaoxing Zhang3Department of Orthopaedic Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital)Department of Orthopaedic Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital)Department of Orthopaedic Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital)Department of Orthopaedic Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital)Abstract Objective The aim of this study was to investigate the relationship between the Chang reduction quality criteria (CRQC) and the outcome of intertrochanteric fractures in older adults according to follow-up time. Methods This was a retrospective analysis of 389 older adult patients with intertrochanteric fractures treated surgically from January 2019 to June 2021, including 130 males and 259 females aged 84.6 (77.5–89.7) years. Patient survival was determined by telephone as the time between admission to hospital for fracture and death or until the study deadline (June 1, 2022). According to the CRQC, the patients were divided into the Poor, Acceptable, and Excellent groups. Univariate and multivariate Cox proportional hazard models were used to assess the association between CRQC and all-cause mortality in older adult intertrochanteric fractures at 1 year and the total follow-up time. Further subgroup analysis was performed according to different clinical and biological characteristics to improve the accuracy of the results. Results The mortality rates were 24.7% and 15.4% at 1 year and the total follow-up time, respectively. Both at one year and the total follow-up time, the mortality of the CRQC-Excellent group was significantly lower than that of the CRQC-Acceptable group (p.adj < 0.05) and the CRQC-Poor group (p.adj < 0.05). After multifactor adjustment, CRQC grades of Acceptable and Poor were independent risk factors affecting the overall and 1-year mortality. In addition, advanced age, ≥ 1 comorbidities, ASA 3 + 4, and prolonged preoperative waiting time were independent risk factors for survival at the total follow-up time. At 1 year, only ASA 3 + 4 and prolonged preoperative waiting time were independent risk factors for survival. Subgroup analysis according to different characteristics at the total follow-up time and at one year showed that in most subgroups, a decrease in the CRQC grade was significantly associated with an increase in all-cause mortality (p for trend < 0.05). Conclusions This study highlights that CRQC grades of Acceptable and Poor are associated with increased all-cause mortality in older adult intertrochanteric fractures. We should attempt to achieve good reduction of these fractures.https://doi.org/10.1186/s12877-022-03641-zChang reduction quality criteriaOlder adultsIntertrochanteric fracturesMortality |
| spellingShingle | Miao He Jian Liu Xu Deng Xiaoxing Zhang The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria BMC Geriatrics Chang reduction quality criteria Older adults Intertrochanteric fractures Mortality |
| title | The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria |
| title_full | The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria |
| title_fullStr | The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria |
| title_full_unstemmed | The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria |
| title_short | The postoperative prognosis of older intertrochanteric fracture patients as evaluated by the Chang reduction quality criteria |
| title_sort | postoperative prognosis of older intertrochanteric fracture patients as evaluated by the chang reduction quality criteria |
| topic | Chang reduction quality criteria Older adults Intertrochanteric fractures Mortality |
| url | https://doi.org/10.1186/s12877-022-03641-z |
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