ArticleGeriatric orthopaedic surgery & rehabilitation2018
Predictors of Mortality in Elder Patients With Proximal Humeral Fracture.
Article in Geriatric orthopaedic surgery & rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- The effects of augmentation choices for locking plate fixation in proximal humerus fracture osteosynthesis: a systematic review and meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Pooled it
- Optimization of high-intensity resistance exercise protocols for improving bone mineral density in the elderly without chronic diseases: a systematic review and network meta-analysis.Frontiers in physiology · 2025Pooled it
- Concomitant Polytrauma in Fall-Related Proximal Humerus Fractures: A Fracture-Subtype-Stratified Analysis of In-Hospital Outcomes.Journal of clinical medicine · 2026Article
- Treatment and prognosis of proximal humerus fracture in older adults: a retrospective cohort study using health insurance claims database.BMC geriatrics · 2026Article
- The impact of prior level of care on the course of proximal humeral fractures in older patients: an analysis based on health insurance claims data.BMC health services research · 2026Article
- Major Upper-Extremity Fractures in Older Adults: Predictors of 5-Year Mortality.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Increased all-cause mortality following proximal humerus fractures in Danish adults: a register-based matched cohort study of 93,952 fracture cases and 469,760 controls.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Which Factors Influence the Need for Inpatient Aftercare of Elderly Patients After Hospital Treatment for Proximal Humerus Fractures?Geriatric orthopaedic surgery & rehabilitation · 2025Article
- 5-Year Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Reverse Total Shoulder Arthroplasty.Journal of clinical medicine · 2024Article
- Identifying clinically meaningful subgroups following open reduction and internal fixation for proximal humerus fractures: a risk stratification analysis for mortality and 30-day complications using machine learning.JSES international · 2024Article
- Factors affecting hospital admission, hospital length of stay and new discharge destination post proximal humeral fracture: a retrospective audit.BMC geriatrics · 2024Article
- Proximal humerus fractures: Postoperative protocols and factors affecting treatment decisions among shoulder and elbow and orthopedic trauma surgeons.Journal of orthopaedics · 2024Article
- Factors influencing choice of treatment for proximal humeral fractures elaborated in a Delphi consensus process.Archives of orthopaedic and trauma surgery · 2023Article
- Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture.Archives of osteoporosis · 2023Article
- Conditional survival after surgery for metastatic tumors of the spine: does prognosis change over time?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- The Reliability and Reproducibility of a New Revised Edelson Classification.Orthopaedic surgery · 2022Article
- Renal disease is a risk factor for complications and mortality after open reduction internal fixation of proximal humerus fractures.JSES international · 2022Article
- Median Effective Analgesic Concentration of Ropivacaine in Ultrasound-Guided Interscalene Brachial Plexus Block as a Postoperative Analgesia for Proximal Humerus Fracture: A Prospective Double-Blind Up-Down Concentration-Finding Study.Frontiers in medicine · 2022Article
- Analysis of predictors of mortality after surgical and non-surgical management in proximal humerus fractures.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2021Article
- Prognostic factors related to ambulation deterioration after 1-year of geriatric hip fracture in a Chinese population.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnown possible consequences of proximal humerus fractures include impaired shoulder function, decreased independence, and increased risk for mortality. The purpose of this report is to describe the survival and independence of elderly patients with fractures of the proximal humerus, treated in our institution, relative to patient characteristics and treatment method.
methodsRetrospective cohort study from 2006 to 2012.
settingCommunity-based hospital with level 1 designation. PATIENTS/
participantsThree hundred nineteen patients ≥60 years who presented to the emergency department with an isolated fracture of the proximal humerus were either admitted to the inpatient ward for the organization and provision of immediate definitive care or discharged with the expectation of coordination of their care as an outpatient. Treatment was nonoperative or operative. OUTCOME MEASURES: One- and 2-year mortality.
resultsSignificant predictors of mortality at 1 year included Charlson Comorbidity Index (CCI; continuous, hazard ratio [HR] = 1.40; 95% confidence interval [CI]: 1.06-1.86), body mass index (BMI; <25 vs ≥25; HR = 3.43; 95% CI: 1.45-8.14), and American Society of Anesthesiologists (ASA) disease severity score (3-4 vs 1-2; HR = 4.48; 95% CI: 1.21-16.55). In addition to CCI and BMI, reliance on a cane/walker/wheelchair at the time of fracture predicted mortality at 2 years (vs unassisted ambulation; HR = 3.13; 95% CI: 1.59-5.88). Although the Neer classification of fracture severity significantly correlated with inpatient admission (
conclusionIn a cohort of elderly patients with fractures of the proximal humerus, patient characteristics including comorbidities, ASA classification, and lower BMI were associated with increased mortality. Specifically, those admitted at the time of fracture and treated nonoperatively had the highest mortality rate and, likely, represent the frailest cohort. Those initially treated as outpatients and later treated operatively had the lowest mortality and, likely, represent the healthiest cohort. These data are inherently biased by prefracture comorbidities but help stratify our patients' mortality risk at the time of injury.
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