| المؤلفون: |
Mosher ZA; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Brabston EW; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Ewing MA; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Pinto MC; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Hess MC; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Behnke NK; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; The Vancouver Clinic, Vancouver, Washington., McGwin G; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama., Ponce BA; Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama., Patt JC; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina; Atrium Health Orthopaedic Surgery, A facility of Carolinas Medical Center, 1025 Morehead Medical Drive Charlotte, NC 28204. |
| مستخلص: |
Pathologic fractures are associated with poor outcomes. This article investigated the prevalence of underestimation of risk by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Surgical Risk Calculator (SRC) in patients with pathologic humerus fractures. Two hundred seven (207) patients were identified and analyzed using the ACS-NSQIP SRC. Predicted and actual outcomes were then compared. Average hospitalization was 6 ± 10 days. Ten patients (5%) had a mild adverse event (AE), and 15 (7%) had a serious AE. The ACS-NSQIP SRC underestimated hospitalizations (p < 0.001), but not serious AE (p = 0.601), mild AE (p = 0.948), cardiac complications (p = 0.817), pneumonia (p = 0.713), surgical site infection (p = 0.692), urinary tract infection (p = 0.286), venous thromboembolism (p = 0.554), acute renal failure (p = 0.191), discharge to acute care facility (p = 0.865), readmission (p = 1.0), reoperation (0.956) or mortality (p = 0.872). Negative outcomes were limited in this cohort, and the SRC demonstrated acceptable accuracy. Future investigation of the calculator in other orthopaedic populations is warranted. (Journal of Surgical Orthopaedic Advances 28(4):250-256, 2019). |
