Predictors of survival after intramedullary nail fixation of completed or impending pathologic femur fractures from metastatic disease

Ronak N. Kotian, Varun Puvanesarajah, Sandesh Rao, Jad M. El Abiad, Carol D. Morris, Adam S. Levin

Research output: Contribution to journalArticle

Abstract

Background: Surgical decision-making can be challenging when treating patients with osseous metastases. Numerous factors, including expected duration of survival, must be considered to ensure optimal operative stabilization of the affected bone. However, life expectancy of patients with metastatic carcinoma is often difficult to estimate. The goal of our study was to assess the associations of various clinical and demographic factors with survival time after intramedullary nail fixation of impending or completed pathologic femur fractures. Methods: One hundred thirty-eight consecutive patients treated with intramedullary nail fixation for impending or completed pathologic femur fractures between 2005 and 2017 were included in this study. Factors related to patient survival were assessed with Cox multivariate survival analysis. For all analyses, p < 0.05 was considered significant. Results: The median overall postoperative survival time was 8.4 months. Lower hemoglobin concentration (p = 0.001), lower albumin concentration (p = 0.002), and having a group 2 primary cancer (p = 0.001) were associated with shorter survival on multivariate analysis. When considering the subgroup of 88 prophylactically stabilized patients, lower hemoglobin concentration (p = 0.005), lower albumin concentration (p = 0.015), and having a group 2 primary cancer (p = 0.037) were predictive of shorter survival. Conclusion: Several factors are associated with shorter survival after intramedullary nail fixation of pathologic femur fractures. These factors should be considered by orthopedic surgeons when educating patients and determining appropriate treatment.

Original languageEnglish (US)
Pages (from-to)462-467
Number of pages6
JournalSurgical Oncology
Volume27
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Carcinoma
  • Duration of survival
  • Femur fractures
  • Intramedullary nail fixation
  • Osseous metastases
  • Risk factors

ASJC Scopus subject areas

  • Surgery
  • Oncology

Fingerprint Dive into the research topics of 'Predictors of survival after intramedullary nail fixation of completed or impending pathologic femur fractures from metastatic disease'. Together they form a unique fingerprint.

  • Cite this