Geriatric-Typical Characteristic Complexes Predict Short-Term Outcome of Proximal Humeral Fractures in Geriatric...

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Patient Outcomes Research

Background:

• Geriatric-typical multimorbidity (GTMM) describes multiple geriatric syndromes in older adults.
• The impact of GTMM on proximal humerus fracture (PHF) outcomes is not well understood.
• Optimizing geriatric care strategies for PHF patients requires understanding GTMM's influence.

Purpose of the Study:

• To evaluate the influence of GTMM on PHF patient outcomes within three months post-fracture.
• To identify specific GTMM components that affect PHF patient prognosis.
• To inform improved geriatric care protocols for PHF management.

Main Methods:

• Retrospective cohort study of patients aged ≥65 with PHF (ICD S42.2) from 2011-2022.
• GTMMs assessed within two years pre-fracture; patients grouped by surgical (RTSA, LPF, sLPF, other) or non-surgical management.
• Multivariable Cox hazard model analyzed associations between GTMMs, treatment groups, and 3-month outcomes (complications, MAE, TE, mortality).

Main Results:

• 95,324 PHF patients identified; 43% surgical, median age 79, 70% geriatric.
• 3-month mortality: 4.3%; MAE: 7.1%; TE: 5.6%.
• GTMM cognitive deficits independently predicted worse outcomes in surgically treated patients. Incontinence and malnutrition increased mortality, MAE, and TE rates across all patients (p < 0.05).

Conclusions:

• GTMMs are significant risk factors associated with poorer outcomes in PHF patients, regardless of treatment.
• Specific GTMM components, including cognitive deficits, incontinence, decubitus ulcers, and malnutrition, significantly increase adverse event rates.
• Findings underscore the need for comprehensive geriatric assessment and management in PHF patients.