ArticleMusculoskeletal surgery2021
Proximal humeral fracture in patients with high Charlson comorbidity index: mortality rate according to treatment choice.
Article in Musculoskeletal surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Risk factors for cephalic necrosis after plate and screw osteosynthesis of 3- and 4-part proximal humerus fractures: prospective cohort study of 121 patients.Musculoskeletal surgery · 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
- 5-Year Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Reverse Total Shoulder Arthroplasty.Journal of clinical medicine · 2024Article
- Predictive prognostic factors in patients with proximal humeral fracture treated with reverse shoulder arthroplasty.Shoulder & elbow · 2024Article
- 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
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this study was to evaluate the relevance of a commonly used morbidity prognostic tool, the Charlson comorbidity index (CCI), in determining the survival rate of patients with isolated proximal humeral fractures (PHFs) and to determine the impact of surgical treatment according to previous comorbidities (measured with CCI). MATERIALS AND
methodsAll patients who were treated for a single PHF in our institution for 29 consecutive months were included in this retrospective study, with a minimum follow-up of 24 months (mean 52.8 months). Two groups were established according to the type of treatment received (surgical versus non-surgical). Preinjury comorbidities were identified, and the age-adapted CCI was calculated. All complications and mortality rates were prospectively recorded over the complete follow-up period.
resultsPatients with elevated preinjury comorbidities (CCI > 5) demonstrated a significant increase in mortality (HR = 4.64) compared to those with CCI ≤ 5. In addition, patients with high comorbidities (CCI > 5) who underwent surgical treatment demonstrated a statistically significant increase in mortality (HR = 6.92) compared to patients with similarly high comorbidities (CCI > 5) who underwent non-surgical treatment.
conclusionsPatients with high preinjury comorbidities (CCI > 5) experienced an increased mortality risk if they underwent surgical treatment for isolated PHFs. The use of a morbidity prognostic tool, such as the CCI, can help predict the outcome (particularly mortality) in these patients and may aid in making decisions in terms of operative versus non-operative treatment to minimize patient mortality. LEVEL OF EVIDENCE: Level III; Retrospective Comparative Study; Treatment Study.
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