Prédiction par l’index de comorbidité de Charlson de la morbidité et des complications après fracture de l’humérus proximal - 31/03/19
Is the Charlson comorbidity index a good predictor of mortality and adverse effects in proximal humerus fractures?
, Jesús Vidal-Campos c, Xavier Paredes-Carnero d, Fernando Marco Martinez eAbstract |
Introduction |
Proximal humerus fractures (PHF) are frequent in elderly patients. This population also suffers from a series of associated comorbidities, and PHF increases morbidity and mortality. The Charlson Comorbidity Index (CCI) is a tool used for calculating comorbidity and therefore the mortality risk.
Hypothesis |
Our hypothesis is that CCI is a good predictor of mortality in patients suffering from PHF, and that there is a relationship between CCI and the development of adverse events.
Patients and methods |
A retrospective study with prospective data collection of 354 patients who had been diagnosed and treated for a single PHF between August 1st, 2013 and July 31st, 2015 was carried out at our hospital. The minimum follow-up was 24 months (mean 51.1 months). This study included all patients regardless the severity of the fracture, the treatment performed (surgical or conservative treatment) or whether the patient had been admitted to the hospital or was treated as an outpatient. Adverse effects and mortality data were collected and the CCI was calculated.
Results |
Patients with high CCI (>5) had a higher mortality risk 4.6 (95% CI [2.4–9.0]) compared to those with CCI<5. During follow-up, 40 (11%) patients died, being the mean follow-up of the patients overall 4.3years 95% CI [4.1–4.4]. Patients suffering from systemic complications had a higher CCI average (p=0.001) compared to those who did not present adverse effects (HR=6.6; 95% CI [3.5–12.4]). No statistically significant relationship between the type of fracture (p=0.473) and mortality was found.
Conclusion |
In our study, CCI has proven to be a good predictor of mortality and there is a relationship between CCI and the development of adverse effects in patients suffering from PHF, which maybe should be taken into consideration in our therapeutic decision making.
Level of evidence |
IV, retrospective observational study.
Le texte complet de cet article est disponible en PDF.Keywords : Proximal humerus fractures, Comorbidity, Charlson comorbidity index, Adverse effects, Mortality
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 105 - N° 2
P. 176 - avril 2019 Retour au numéro
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