A novel scoring system to guide prognosis in patients with pathological fractures

Xiang Salim, Peter D'Alessandro, James Little, Kulvir Mudhar, Kevin Murray, Richard Carey Smith, Piers Yates

    Research output: Contribution to journalArticle

    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 languageEnglish
    Article number228
    JournalJournal of Orthopaedic Surgery and Research
    Volume13
    Issue number1
    DOIs
    Publication statusPublished - 6 Sep 2018

    Fingerprint

    Spontaneous Fractures
    Survival
    Life Expectancy
    Radiotherapy
    Drug Therapy
    Neoplasms
    Fracture Fixation
    Western Australia
    Orthopedics
    Therapeutics

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    Salim, Xiang ; D'Alessandro, Peter ; Little, James ; Mudhar, Kulvir ; Murray, Kevin ; Carey Smith, Richard ; Yates, Piers. / A novel scoring system to guide prognosis in patients with pathological fractures. In: Journal of Orthopaedic Surgery and Research. 2018 ; Vol. 13, No. 1.
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    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.",
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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 journalArticle

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    AU - Little, James

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    AU - Murray, Kevin

    AU - Carey Smith, Richard

    AU - Yates, Piers

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