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Predictors of survival after intramedullary nail fixation of completed or impending pathologic femur fractures from metastatic disease.
- Source :
-
Surgical oncology [Surg Oncol] 2018 Sep; Vol. 27 (3), pp. 462-467. Date of Electronic Publication: 2018 May 31. - Publication Year :
- 2018
-
Abstract
- Background: Surgical decision-making can be challenging when treating patients with osseous metastases. Numerous factors, including expected duration of survival, must be considered to ensure optimal operative stabilization of the affected bone. However, life expectancy of patients with metastatic carcinoma is often difficult to estimate. The goal of our study was to assess the associations of various clinical and demographic factors with survival time after intramedullary nail fixation of impending or completed pathologic femur fractures.<br />Methods: One hundred thirty-eight consecutive patients treated with intramedullary nail fixation for impending or completed pathologic femur fractures between 2005 and 2017 were included in this study. Factors related to patient survival were assessed with Cox multivariate survival analysis. For all analyses, p < 0.05 was considered significant.<br />Results: The median overall postoperative survival time was 8.4 months. Lower hemoglobin concentration (p = 0.001), lower albumin concentration (p = 0.002), and having a group 2 primary cancer (p = 0.001) were associated with shorter survival on multivariate analysis. When considering the subgroup of 88 prophylactically stabilized patients, lower hemoglobin concentration (p = 0.005), lower albumin concentration (p = 0.015), and having a group 2 primary cancer (p = 0.037) were predictive of shorter survival.<br />Conclusion: Several factors are associated with shorter survival after intramedullary nail fixation of pathologic femur fractures. These factors should be considered by orthopedic surgeons when educating patients and determining appropriate treatment.<br /> (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Bone Neoplasms secondary
Bone Neoplasms surgery
Female
Femur pathology
Follow-Up Studies
Fractures, Spontaneous pathology
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Young Adult
Bone Nails
Bone Neoplasms mortality
Femur surgery
Fractures, Spontaneous mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1879-3320
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30217303
- Full Text :
- https://doi.org/10.1016/j.suronc.2018.05.028