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Article

Prognostic Factors of 1-Year Postoperative Functional Outcomes of Older Patients with Intertrochanteric Fractures in Thailand: A Retrospective Cohort Study

1
Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2
Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
3
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
4
Musculoskeletal Science and Translational Research (MSTR) Cluster, Chiang Mai University, Chiang Mai 50200, Thailand
5
Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
*
Author to whom correspondence should be addressed.
Academic Editors: Francisco José Tarazona Santabalbina, Sebastià Josep Santaeugènia Gonzàlez, José Augusto García Navarro and José Viña
Int. J. Environ. Res. Public Health 2021, 18(13), 6896; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136896
Received: 12 May 2021 / Revised: 17 June 2021 / Accepted: 25 June 2021 / Published: 27 June 2021
(This article belongs to the Special Issue Health Care for Older Adults)
Restoration of ambulatory status is considered a primary treatment goal for older patients with intertrochanteric fractures. Several surgical-related parameters were reported to be associated with mechanical failure without focusing on the functional outcomes. Our study examines the roles of both clinical and surgical parameters as prognostic factors on 1-year postoperative ambulatory outcomes, reaching a good functional outcome (the New Mobility Score: NMS ≥ 5) and returning to preinjury functional status at one year, of older patients with intertrochanteric fracture. Intertrochanteric fractures patients age ≥65 years who underwent surgical treatment at our institute between January 2017 and February 2020 were included. Of 209 patients included, 149 (71.3%) showed a good functional outcome at one year. The pre-injury ambulatory status (OR 52.72, 95%CI 5.19–535.77, p = 0.001), BMI <23 kg/m2 (OR 3.14, 95%CI 1.21–8.13, p = 0.018), Hb ≥10 g/dL (OR 3.26, 95%CI 1.11–9.57, p = 0.031), and NMS at discharge ≥2 (OR 8.50, 95%CI 3.33–21.70, p < 0.001) were identified as independent predictors for reaching a good postoperative functional outcome. Only aged ≤80 (OR 2.34, 95%CI 1.11–4.93, p = 0.025) and NMS at discharge ≥2 (OR 6.27, 95%CI 2.75–14.32, p < 0.001) were significantly associated with an ability to return to preinjury function. To improve postoperative ambulatory status, orthopedic surgeons should focus more on modifying factors, such as maintaining the preoperative hemoglobin ≥10 g/dL and providing adequate postoperative ambulation training to maximize the patients’ capability upon discharge. While surgical parameters were not identified as predictors, they can still be used as guidance to optimize the operation quality. View Full-Text
Keywords: fracture fixation; geriatric; intertrochanteric fractures; prognostic factors; Thai fracture fixation; geriatric; intertrochanteric fractures; prognostic factors; Thai
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MDPI and ACS Style

Adulkasem, N.; Phinyo, P.; Khorana, J.; Pruksakorn, D.; Apivatthakakul, T. Prognostic Factors of 1-Year Postoperative Functional Outcomes of Older Patients with Intertrochanteric Fractures in Thailand: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 6896. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136896

AMA Style

Adulkasem N, Phinyo P, Khorana J, Pruksakorn D, Apivatthakakul T. Prognostic Factors of 1-Year Postoperative Functional Outcomes of Older Patients with Intertrochanteric Fractures in Thailand: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(13):6896. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136896

Chicago/Turabian Style

Adulkasem, Nath, Phichayut Phinyo, Jiraporn Khorana, Dumnoensun Pruksakorn, and Theerachai Apivatthakakul. 2021. "Prognostic Factors of 1-Year Postoperative Functional Outcomes of Older Patients with Intertrochanteric Fractures in Thailand: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 18, no. 13: 6896. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136896

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