Tibial plateau fractures are associated with a long-term increased risk of mortality: a matched cohort study of 7950 pat
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TRAUMA SURGERY
Tibial plateau fractures are associated with a long‑term increased risk of mortality: a matched cohort study of 7950 patients Rasmus Elsoe1 · Peter Larsen2 Received: 23 October 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Disregarding proximal femoral fractures, the current literature includes only limited information regarding mortality following lower extremity fractures. Information regarding risk of mortality related to specific fracture patterns is essential when planning treatment modalities. The primary aim of this study was to report the long-term cumulative survival rate in patients with a tibial plateau fracture compared to an age- and gender-matched reference population. Materials and methods Patients who sustained a tibial plateau fracture in Denmark between 1996 and 2000 were included in the study. Survival status was monitored until 2015. We compared the mortality rate with a tenfold reference population matched on age and gender without a prior tibial plateau fracture. The study was based on register data from the Danish National Patient Register. Results The study included 7950 patients sustaining 8065 tibial plateau fractures. The cohort had a mean follow-up period of 13.9 years. Patients with a tibial plateau fracture had a 1.52 (95% CI 1.46–1.58) times higher hazard ratio (HR) of death compared to the age- and gender-matched reference population. The 30-day, 6-month and 1-year mortality rates were 1.2%, 3.3% and 4.9%, respectively. Conclusion Patients with a proximal tibial plateau fracture have a higher cumulative risk of death during the mean 13.9-year observational period compared to an age- and gender-matched reference population. Keywords Knee · Fracture · Mortality
Introduction The association between femoral neck fractures and increased mortality is well recognised [1–4]. Furthermore, the association between geriatric lower extremity fractures and increased mortality has previously been reported [5–9]. Other fractures of the lower extremities, such as patella fractures and periprosthetic fractures, are also reported with increased mortality [10, 11]. However, the current literature includes only limited information regarding mortality following almost all other lower extremity fractures. Information regarding risk of mortality related to specific fracture * Rasmus Elsoe [email protected] 1
Department of Orthopaedic Trauma Surgery, Aalborg University Hospital, 18‑22 Hobrovej, 9000 Aalborg, Denmark
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
2
patterns is essential when planning treatment modalities. Recognising an increased risk of mortality in a specific group of patients might indicate that a revision of patient care and surgical protocols may be necessary. Fractures of the tibial plateau are reported with an incidence of 10.3/100,000/year [12]. A single study reports the 90-day mortality rate for surgically treated adult patients with tibial plateau fractures to be
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