Publication: Correlation between perioperative surgical factors and complications after hip arthroplasty, as a salvage procedure, following failure of internal fixation of osteoporotic intertrochanteric fractures
Issued Date
2019-01-01
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11791462
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2-s2.0-85060367219
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Mahidol University
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SCOPUS
Bibliographic Citation
Orthopedic Research and Reviews. Vol.11, (2019), 9-15
Suggested Citation
Noratep Kulachote, Paphon Sa-Ngasoongsong, Siwadol Wongsak, Kulapat Chulsomlee, Chavarat Jarungvittayakon, Praman Fuangfa, Viroj Kawinwonggowit, Pornchai Mulpruek Correlation between perioperative surgical factors and complications after hip arthroplasty, as a salvage procedure, following failure of internal fixation of osteoporotic intertrochanteric fractures. Orthopedic Research and Reviews. Vol.11, (2019), 9-15. doi:10.2147/ORR.S185228 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/52145
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Title
Correlation between perioperative surgical factors and complications after hip arthroplasty, as a salvage procedure, following failure of internal fixation of osteoporotic intertrochanteric fractures
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Abstract
© 2019 Kulachote et al. Background and purpose: Salvage hip arthroplasty (SHA) in patients presenting with failed internal fixation after intertrochanteric fracture (FIF-ITFx) is a difficult procedure, and the incidence of perioperative mortality and complications following SHA are high. To our knowledge, no information related to the correlation between perioperative surgical factors and post-SHA perioperative complications in these patients has been demonstrated. This study aimed to identify the predictive factors for post-SHA perioperative complications in patients with FIF-ITFx. Materials and methods: A total of 32 patients with FIF-ITFx who underwent SHA between 2010 and 2017 were retrospectively reviewed. All patients had been followed for 1 year post-operatively. Perioperative data and complication details related to fracture and treatment were collected. Predictive factors for post-SHA perioperative complications were analyzed via logistic regression analysis. Results: Two (6%) patients died after SHA during the admission period. Perioperative complications were found in 16 (50%) patients, including surgical (n=3, 9%) and medical (n=15, 47%) complications, respectively. By univariate analysis, age (P=0.043), American Society of Anesthesiologist (ASA) grade 4 (P=0.016), Charlson Comorbidity Index (CCI; P=0.014), lymphocyte cell count (P=0.064), and serum albumin level (P=0.146) were correlated with the perioperative complications. However, multivariate regression analysis showed that CCI was the only significant independent predictor for post-SHA perioperative complications in these patients (OR=1.87; 95% CI, 1.14–2.07, P=0.014). Conclusion: Our study showed that post-SHA perioperative complications in patients with FIF-ITFx are very common and predictable with a simple preoperative factor CCI. Therefore, special perioperative attention must be paid to patients with FIF-ITFx undergoing SHA and having multiple severe comorbid diseases or high CCI.