30-Day Mortality Rates in Fractured Neck of Femur: Nottingham Hip Fracture Score vs Surgical Outcome Risk Tool
Michael Tang1, William Fowler1, Oday Al-Dadah1,2*
1Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, Harton Lane, South Tyneside, United Kingdom
2Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, United Kingdom
Objectives: The Nottingham hip fracture score (NHFS) and the Surgical outcome risk tool (SORT) are both validated scoring systems used to predict mortality rates in patient with Fractured neck of femur (FnF). The primary aim of this study was to compare the accuracy of the predicted 30-day mortality rates between NHFS and SORT in patients with FnF. The secondary aim was to investigate the influence of patient and surgical factors on 30-day mortality.
Methods: The NHFS and SORT score was collected from 212 patients admitted with FnF. Variables including hip fracture type, surgical procedure and peri-operative haemoglobin, gender and ASA grade were also collected and further analysed to assess their influence on 30-day mortality rates.
Results: Overall actual 30-day mortality rate for the study population was 11.3% (n=24). There was a significant difference between the mean predicted 30-day mortality for the NHFS (8.0%) and the SORT score (7.0%, p=0.006). The was no difference in mortality rates between the different fracture types (p=0.889). There was a significant difference in mortality rates when comparing surgical procedures (p=0.031). Patients who had a notable fall in haemoglobin peri-operatively had significantly higher mortality rates (p<0.001). Males had significantly higher mortality rates compared to females (20.0% vs 8.6% respectively, p=0.027). Higher ASA grades also had significantly higher mortality rates (p=0.003).
Conclusion: NHFS was found to be significantly more accurate at calculating 30-day mortality rates compared to the SORT score in patients with FnF. Surgical procedure and patient factors including gender, ASA grade and peri-operative haemoglobin also significantly influenced mortality rates but fracture type did not.DOI: 10.29245/2767-5130/2023/1.1166 View / Download Pdf
Commentary: Systematic review on the application of 3D-bioprinting technology in orthoregeneration: current achievements and open challenges
DOI: 10.29245/2767-5130/2023/1.1172 View / Download Pdf
Thomas J. Kean
Biionix Cluster, Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA
Therapeutic Arterial Embolization in Patients with Shoulder Adhesive Capsulitis: A Systematic Review
Amina Ait Belmahjoub Aamre MD1, Sergio Barroso Rosa FEBOT PhD1,2*
1Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
2Department of Orthopaedics, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
Introduction: Currently there are limited options for shoulder adhesive capsulitis treatment, some of which do not have sufficient backing scientific evidence. This entails a relevant setback for patients, especially in severe or refractory cases. In recent years, remote arterial embolization therapies have demonstrated usefulness in the management of diverse musculoskeletal conditions. This systematic review examines the therapeutic role of arterial embolization in patients with shoulder adhesive capsulitis.
Methods: A systematic review of articles published to date was performed, according to the methodology in the Cochrane Systematic Reviews Manual (MECIR) and the PRISMA checklists. PubMed, Scopus, Google Scholar, three other databases and three trial registries were examined for relevant studies. The ROBINS-I tool was used for quality assessment of included studies.
Results: Ninety four potential articles were found, seven of which were included. In the selected studies, arterial embolization was carried out in 127 patients, 113 of whom had abnormal vessels. In all studies, a reduction in pain and improvement in mobility was observed in less than six months after the procedure. There were no major adverse effects or recurrent symptoms reported. Due to large data heterogeneity, a meta-analysis was not performed. Three literature reviews were also included as part of the background discussion.
Conclusions: Arterial embolization is an effective and safe treatment option in patients with shoulder adhesive capsulitis, resulting in reduced pain and restored joint function. Controlled randomized trials are required to evaluate the attributable effect of the technique to the reported clinical improvement.DOI: 10.29245/2767-5130/2023/1.1170 View / Download Pdf