Evidence map›Paper›PMID 35866693›Full record

Observational studyActa orthopaedica2022

Lower mortality in distal femoral fractures in the presence of a knee arthroplasty: an observational study on 2,725 fractures from the Swedish Fracture Register.

Björn Hernefalk, Anders Brüggemann, Jabbar Mohammed, Sebastian Mukka, Olof Wolf

Abstract readObservational Study
In one paragraph

Observational study in Acta orthopaedica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Björn HernefalkDepartment of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala. bjorn.hernefalk@surgsci.uu.se.
Anders BrüggemannDepartment of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala.
Jabbar MohammedDepartment of Surgical and Perioperative Sciences at Umeå University, Umeå, Sweden.
Sebastian MukkaDepartment of Surgical and Perioperative Sciences at Umeå University, Umeå, Sweden.
Olof WolfDepartment of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeDistal femoral fractures (DFF) in older patients have mortality rates comparable to fractures of the proximal femur. An ageing population combined with an increasing number of patients undergoing total knee arthroplasty (TKA) will make periprosthetic distal femoral fractures (pDFF) more common. We investigated whether a pre-existing TKA influences mortality rates. PATIENTS AND

methodsAll patients ≥ 60 years registered in the Swedish Fracture Register with a DFF sustained between March 20, 2011 and December 31, 2020 were included. The study cohort comprised 2,725 patients, of which 650 had a pDFF. Unadjusted 90-day and 1-year mortality was estimated via Kaplan-Meier survival curves. A Cox regression model adjusted for age, sex, and treatment modality was used to investigate the association between DFF or pDFF and mortality.

resultsMean age was 80 years and 82% were females. The most common injury mechanism was a simple fall (75%). The pDFF and DFF group were similar with regards to age, sex, and trauma mechanism. Unadjusted 90-day and 1-year mortality was 11% (95% CI 10-12) and 21% (CI 19-23), respectively. Kaplan-Meier survival analysis demonstrated a slightly lower mortality for pDFFs, especially in patients ≤ 70 years. The Cox regression model showed a lower hazard ratio (HR) for mortality in the pDFF group (HR 0.82, CI 0.71-0.94).

interpretationIn a large cohort of patients ≥ 60 years with a distal femoral fracture, mortality rates at 90 days and 1 year post-injury were 11% and 21%, respectively. Periprosthetic fractures were associated with a lower mortality.

Indexed as

Arthroplasty, Replacement, KneeFemoral FracturesPeriprosthetic FracturesAgedAged, 80 and overFemaleFemurHumansMaleSweden

Identifiers

PMID35866693
PMCPMC9306289

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.