The Pathologic Fracture Mortality Index: A Novel Externally
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
The purpose of this study is to develop a validated research and clinical tool that is superior to existing methods in estimating postoperative mortality risk after fixation of pathologic fractures. Clinical decision making and mortality prediction in research would benefit from creation of a high-fidelity scoring system for calculating the risk of 30-day postoperative mortality.

1219 patients who underwent fixation for either completed or impending pathologic fractures in the National Surgical Quality Improvement Program (2012 to 2018) database were analyzed. Area under the curve (AUC) from receiver operator curve analysis was used to assess accuracy. A score was derived and compared with the American Society of Anesthesiologists classification and modified five-component frailty index (mF-I5). The score was validated in an exclusive cohort of patients who underwent fixation for pathologic fractures at a tertiary care center.

Results:
--Of 1,219, a total of 177 patients did not survive beyond 30 days postoperatively. AUC for this predictive model was 0.76 in the derivation and 0.75 in the validation National Surgical Quality Improvement Program cohorts.

--The derived Pathologic Fracture Morbidity Index included seven data points: anemia, alkaline phosphatase more than 150 U/L, albumin less than 3.5 mg/dL, pulmonary disease, recent weight loss, functional dependence, and white blood cell count more than 12,000.

--The PFMI (AUC = 0.75) was more accurate than ASA (AUC = 0.60) or mF-5 (AUC = 0.58). The AUC for PFMI in predicting 30-day mortality in the exclusive cohort (N = 39) was 0.74.

To summarize, the PFMI is a validated instrument that can be used to predict 30-day mortality after pathologic fracture fixation with a higher degree of precision than the ASA or mF-I5.

Source: https://journals.lww.com/jaaos/Abstract/9900/The_Pathologic_Fracture_Mortality_Index__A_Novel.138.aspx
Like
Comment
Share