Clinical importance of comorbidity in patients with a proximal humerus fracture

The aim of this prospective study of 100 consecutive patients with a proximal humerus fractures primarily was to investigate the prevalence and importance of poor health and comorbidity. Seventeen men and 83 women with a mean age of 73 years were involved together with 138 age and gender-matched controls. Twenty patients with a mean age of 81 years, were severely ill with a physical and/or mental disorder when they got their proximal humerus fracture. The 1-year mortality of this subgroup was 40% compared with 8% in the control group. Fifty-seven patients with a mean age of 74 years reported concomitant disorders compared with 54 of 78 (69%) controls. Twenty-three patients with a mean age of 67 years, reported no comorbidity compared with 25 of 34 (74%) in the control group. Sixty-seven patients were followed up on for 1 year and were evaluated clinically and radiographically. The Constant-Murley shoulder assessment was used. The 12 surviving severely ill patients were not able to attend the followup evaluation. In the remaining patients there was no significant difference after 1 year in pain, function, Constant-Murley score or radiographic healing of the injured shoulder between individuals with or without comorbidity. Patients with symptomatic shoulders at followup initially had significantly more frequently displaced fractures.

Prognostic study, Level II (prospective study). See the Guidelines for Authors for a complete description of levels of evidence.