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375
Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending
Patrick Qi Wang1, Brynn P Charron1, Kalter Hali2
1Western University, London, Ontario, Canada.
International Journal of Surgical Oncology
|September 20, 2024
Summary
Identifying risk factors for early complications and mortality after surgery for bone metastases is crucial. Pathologic fractures and extra-skeletal metastases independently predict poor outcomes, guiding better patient care.
Area of Science:
- Orthopedic oncology
- Surgical oncology
- Cancer survivorship
Background:
- Improved cancer survival increases focus on surgical risks for metastatic bone disease.
- Perioperative morbidity and mortality are critical considerations in managing bone metastases.
Purpose of the Study:
- To identify risk factors for early postoperative complications.
- To identify risk factors for early postoperative mortality following extremity prophylactic fixation and pathologic fracture stabilization.
Main Methods:
- Retrospective review of 185 patients (226 surgeries) for extremity metastatic bone disease (2005-2020).
- Exclusion of skull, spine, pelvic, revision surgeries, and primary bone neoplasms.
- Univariate, multivariate, and subgroup analyses to determine predictors of 30-day morbidity and mortality.
Main Results:
- 30-day complication rate was 32.30% and mortality rate was 17.26%.
- Common complications included pulmonary issues, cardiac events, infections, sepsis, and thromboembolism.
- Pathologic fracture and extra-skeletal metastases were independent predictors of complications and mortality. Increased blood transfusion also predicted mortality.
Conclusions:
- Study findings aid perioperative risk assessment and patient counseling for bone metastases surgery.
- Enhanced clinical assessment tools are needed to identify patients at risk for pathologic fractures.
- Managing risks associated with pathologic fracture treatment is vital due to significant morbidity and mortality.
