Abstract
Background: The most appropriate treatment of pathological fractures from metastatic disease depends on several factors, one of the most important being predicted life expectancy. The aim of this study was to identify the variables that influence prognosis and utilise these to develop a novel scoring system to better predict life expectancy post-pathological fracture. Methods: The records of all patients that presented with metastatic pathological fractures over a 10-year period from the only tertiary orthopaedic departments in Western Australia were retrospectively examined. Variables assessed were primary cancer type, fracture site, fixation method, cement augmentation, pre-morbid level of physical functioning, complication rate, treatment with chemotherapy or radiotherapy and appendicular, spinal and visceral metastatic load. Results: A total of 233 patients were included. Median survival from fracture to death was 4.1months. Median time from cancer diagnosis to pathological fracture was 14.2months. There was a statistically significant association between patient survival and primary cancer type, physical functional score, spinal metastatic burden and use of chemotherapy or radiotherapy. Conclusion: A novel scoring system has been developed that offers a survival probability based on patient's individual circumstances. This can guide specialist management and offer patients a more accurate expectation of functional outcome and survival time.
| Original language | English |
|---|---|
| Article number | 228 |
| Journal | Journal of Orthopaedic Surgery and Research |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 6 Sep 2018 |
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A novel scoring system to guide prognosis in patients with pathological fractures. / Salim, Xiang; D'Alessandro, Peter; Little, James; Mudhar, Kulvir; Murray, Kevin; Carey Smith, Richard; Yates, Piers.
In: Journal of Orthopaedic Surgery and Research, Vol. 13, No. 1, 228, 06.09.2018.Research output: Contribution to journal › Article
TY - JOUR
T1 - A novel scoring system to guide prognosis in patients with pathological fractures
AU - Salim, Xiang
AU - D'Alessandro, Peter
AU - Little, James
AU - Mudhar, Kulvir
AU - Murray, Kevin
AU - Carey Smith, Richard
AU - Yates, Piers
PY - 2018/9/6
Y1 - 2018/9/6
N2 - Background: The most appropriate treatment of pathological fractures from metastatic disease depends on several factors, one of the most important being predicted life expectancy. The aim of this study was to identify the variables that influence prognosis and utilise these to develop a novel scoring system to better predict life expectancy post-pathological fracture. Methods: The records of all patients that presented with metastatic pathological fractures over a 10-year period from the only tertiary orthopaedic departments in Western Australia were retrospectively examined. Variables assessed were primary cancer type, fracture site, fixation method, cement augmentation, pre-morbid level of physical functioning, complication rate, treatment with chemotherapy or radiotherapy and appendicular, spinal and visceral metastatic load. Results: A total of 233 patients were included. Median survival from fracture to death was 4.1months. Median time from cancer diagnosis to pathological fracture was 14.2months. There was a statistically significant association between patient survival and primary cancer type, physical functional score, spinal metastatic burden and use of chemotherapy or radiotherapy. Conclusion: A novel scoring system has been developed that offers a survival probability based on patient's individual circumstances. This can guide specialist management and offer patients a more accurate expectation of functional outcome and survival time.
AB - Background: The most appropriate treatment of pathological fractures from metastatic disease depends on several factors, one of the most important being predicted life expectancy. The aim of this study was to identify the variables that influence prognosis and utilise these to develop a novel scoring system to better predict life expectancy post-pathological fracture. Methods: The records of all patients that presented with metastatic pathological fractures over a 10-year period from the only tertiary orthopaedic departments in Western Australia were retrospectively examined. Variables assessed were primary cancer type, fracture site, fixation method, cement augmentation, pre-morbid level of physical functioning, complication rate, treatment with chemotherapy or radiotherapy and appendicular, spinal and visceral metastatic load. Results: A total of 233 patients were included. Median survival from fracture to death was 4.1months. Median time from cancer diagnosis to pathological fracture was 14.2months. There was a statistically significant association between patient survival and primary cancer type, physical functional score, spinal metastatic burden and use of chemotherapy or radiotherapy. Conclusion: A novel scoring system has been developed that offers a survival probability based on patient's individual circumstances. This can guide specialist management and offer patients a more accurate expectation of functional outcome and survival time.
KW - Metastases
KW - Pathological fracture
KW - Scoring system
KW - Survival probability
UR - http://www.scopus.com/inward/record.url?scp=85052961572&partnerID=8YFLogxK
U2 - 10.1186/s13018-018-0931-x
DO - 10.1186/s13018-018-0931-x
M3 - Article
VL - 13
JO - Journal of Orthopaedic Surgery and Research
JF - Journal of Orthopaedic Surgery and Research
SN - 1749-799X
IS - 1
M1 - 228
ER -