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Knauf T, Eschbach D, Bücking B, Knobe M, Rascher K, Schoeneberg C, Bliemel C, Ruchholtz S, Aigner R, Bökeler U. [Effects of the COVID-19 pandemic on the course of geriatric trauma patients with proximal femoral fractures]. Unfallchirurgie (Heidelb) 2024; 127:228-234. [PMID: 37994922 DOI: 10.1007/s00113-023-01384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND/OBJECTIVE In 2020 the COVID-19 pandemic posed a major challenge to the healthcare system. The hypothesis is that the COVID-19 pandemic in 2020 had an impact on the care of older adults with proximal femoral fractures due to resource scarcity, regardless of whether or not the patient was infected. MATERIAL AND METHODS This study analyzed the data of 87 hospitals which entered 15,289 patients in the Geriatric Trauma Register ("AltersTraumaRegister DGU®", ATR-DGU) in Germany in 2019 and 2020. In this study we analyzed the influence of the COVID-19 pandemic on the inpatient treatment of hip fractures as well as the mid-term follow-up during the first 120 days. For the main analysis, we compared patients documented during the COVID-19 pandemic in 2020 (April-December) with a control group in 2019 (April-December). Additionally, we performed a subgroup analysis of the periods with high COVID-19 incidence rates. RESULTS Between 2019 and 2020 a total of 11,669 patients (2020: n = 6002 patients vs. 2019: n = 5667 patients) were included in this study. Only minor differences were found between the patients treated during the pandemic; however, when the COVID-19 incidence in Germany was greater than 50/100,000 residents, significantly fewer patients (p < 0.001) were discharged to a geriatric rehabilitation ward (27.2% vs. 36.3%) and an increased mortality rate during inpatient treatment was determined (8.4% vs. 4.6%) (p < 0.001). DISCUSSION The healthcare system was able to respond to the pandemic and patients' clinical courses were not impaired as long as the incidences were low. Nevertheless, the healthcare system reached its limits in times of higher incidence, which was also directly reflected in the patient outcome, mortality and place of discharge.
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Affiliation(s)
- Tom Knauf
- Orthopädische Klinik Hessisch Lichtenau, Am Mühlenberg, 37235, Hessisch Lichtenau, Deutschland.
| | - Daphne Eschbach
- MVZ Hessisch Lichtenau e.V., Kaufungen und Kassel, Deutschland
| | | | - Matthias Knobe
- Abteilung für Unfallchirurgie, Klinikum Hochsauerland, Arnsberg, Deutschland
| | - Katherine Rascher
- AUC - Akademie der Unfallchirurgie GmbH, 80538, München, Deutschland
| | - Carsten Schoeneberg
- Abteilung für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus, Essen, Deutschland
| | - Christopher Bliemel
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
| | - Steffen Ruchholtz
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
| | - Rene Aigner
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
| | - Ulf Bökeler
- Marienhospital Stuttgart, Stuttgart, Deutschland
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Pass B, Sieben D, Malek F, Hussmann B, Maek T, Aigner R, Bliemel C, Dirkmann D, Lendemans S, Schoeneberg C. Liberal intraoperative fluid management leads to increased complication rates in geriatric patients with hip fracture. Eur J Trauma Emerg Surg 2023; 49:2485-2493. [PMID: 37436466 DOI: 10.1007/s00068-023-02326-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/01/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE Fractures of the proximal femur in geriatric patients are life-changing and life-threatening events. Previous research has identified fluid volume as an independent factor contributing to trauma patients' complications. Therefore, we aimed to investigate the impact of intraoperative fluid volume on outcomes in geriatric patients undergoing hip fracture surgery. METHODS We conducted a retrospective single-center study with data from the hospital information systems. Our study included patients aged 70 years or older who had sustained a proximal femur fracture. We excluded patients with pathologic, periprosthetic, or peri-implant fractures and those with missing data. Based on the fluids given, we divided patients into high-volume and low-volume groups. RESULTS Patients with a higher American Society of Anesthesiologists (ASA) grade and more comorbidities were more likely to receive more than 1500 ml of fluids. We observed significant differences in anesthesiologic management between the two groups, with a higher rate of invasive blood pressure management (IBP) and central venous catheter usage in the high-volume group. High-volume therapy was associated with a higher rate of complications (69.7% vs. 43.6%, p < 0.01), a higher transfusion rate (odds ratio 1.91 [1.26-2.91]), and an increased likelihood of patients being transferred to an intensive care unit (17.1% vs. 6.4%, p = 0.009). These findings were confirmed after adjusting for ASA grade, age, sex, type of fracture, Identification-of-Seniors-At-Risk (ISAR) score, and intraoperative blood loss. CONCLUSIONS Our study suggests that intraoperative fluid volume is a significant factor that impacts the outcome of hip fracture surgery in geriatric patients. High-volume therapy was associated with increased complications.
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Affiliation(s)
- Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Denis Sieben
- Department of Orthopedics, Emergency Surgery and Hand Surgery, Florence-Nightingale-Hospital, Duesseldorf, Germany
| | - Fahd Malek
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Bjoern Hussmann
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
- Department of Orthopedics and Trauma Surgery, University Hospital Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
- Department of Orthopedics and Trauma Surgery, Alfried Krupp Hospital Essen, Alfried-Krupp-Straße 21, 45131, Essen, Germany.
| | - Teresa Maek
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Christopher Bliemel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Daniel Dirkmann
- Department of Anesthesiology, Intensive Care and Pain Medicine, Alfried Krupp Hospital, Essen, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
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Aigner R, Föhr J, Lenz J, Knauf T, Bäumlein M, Ruchholtz S, Oberkircher L, Hack J. Cemented Sacroiliac Screw Fixation versus Conservative Therapy in Fragility Fractures of the Posterior Pelvic Ring: A Matched-Pair Analysis of a Prospective Observational Study. J Clin Med 2023; 12:5850. [PMID: 37762790 PMCID: PMC10531520 DOI: 10.3390/jcm12185850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/20/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this study was to compare the outcome of cemented sacroiliac screw fixation to that of conservative treatment in nondisplaced fragility fractures of the sacrum during a 12-month follow-up. Therefore, matched-pair analysis including 40 patients from a previously performed prospective observational study was conducted. Pain was assessed using the visual analogue scale (VAS), functional capabilities and mobility were assessed using the Barthel index, and health-related quality of life (HRQL) was assessed using the EQ-5D questionnaire at 6 weeks, 6 months, and 12 months after the fracture, respectively. No significant differences between the two groups were seen regarding pain. In the operative group, a significantly improved Barthel index was observed after 6 months. A significantly higher HRQL was identified after 6 weeks in the operative group. Their mobility was comparable between the two groups before the fracture; after 6 weeks, mobility was significantly improved in the operative group. After 12 months, no significant differences were found regarding the functional outcome, HRQL or mobility. The 1-year mortality rate was 25% in the conservative group versus 5% in the operative group (not statistically significant). The present study revealed favorable short-term outcomes concerning the functional outcome, HRQL and mobility after sacroiliac screw fixation. After 12 months, the outcomes were similar to those of the patients managed conservatively.
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Affiliation(s)
- Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Jan Föhr
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Julia Lenz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Martin Bäumlein
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
| | - Ludwig Oberkircher
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
- Department for Trauma Surgery, Orthopaedic Surgery and Arthroplasty, Medizin Campus Bodensee, 88048 Friedrichshafen, Germany
| | - Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, 35043 Marburg, Germany
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Pass B, Knauf T, Knobe M, Rascher K, Bliemel C, Maslaris A, Aigner R, Dirkmann D, Lendemans S, Schoeneberg C. Spinal anesthesia with better outcome in geriatric hip fracture surgery - An analysis of the Registry for Geriatric Trauma (ATR-DGU). Injury 2023:S0020-1383(23)00298-X. [PMID: 37032184 DOI: 10.1016/j.injury.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Literature shows conflicting results regarding spinal (SA) or general anesthesia (GA) and their influence on the outcome of elderly patients with hip fractures. We, therefore, conducted an analysis from the Registry for Geriatric Trauma (ATR-DGU). METHODS A retrospective, multicenter registry study including patients aged 70 years or above with hip fractures requiring surgery from 131 Centers for Geriatric Trauma (AltersTraumaZentrum DGU®) from 2016 to 2021. Patients with SA or GA were compared using matched-pair analysis and linear and logistic regression models. RESULTS A total of 43,714 patients were included, of whom 3,242 received SA. The median age was 85 (SA) and 84 years (GA). Adjustments for the American Society of Anesthesiologists (ASA) grade, sex, age, additional injuries, and anticoagulation resulted in a higher in-hospital (odds ratio (OR) 1.31; 95% confidence interval [CI], 1.07 - 1.61, p = 0.009) and 120 days mortality (OR 1.47; 95% CI, 1.1 - 1.95, p = 0.009) in the GA group. GA had a significant negative influence on walking ability seven days after surgery and on the quality of life (QoL). The length of hospital stay (LoS) was significantly shorter in the SA group. CONCLUSIONS SA is associated with a higher survival rate, a better walking ability seven days after surgery, a higher QoL, and a shorter LoS.
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Affiliation(s)
- Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - Tom Knauf
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - Matthias Knobe
- Medical Faculty, University of Zurich, Zurich, Switzerland; Medical Faculty, RWTH Aachen University Hospital, Aachen, Germany.
| | | | - Christopher Bliemel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - Alexander Maslaris
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - Daniel Dirkmann
- Department of Anesthesiology, Intensive Care and Pain Medicine, Alfried Krupp Hospital Essen, Germany.
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
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Pass B, Malek F, Rommelmann M, Aigner R, Knauf T, Eschbach D, Hussmann B, Maslaris A, Lendemans S, Schoeneberg C. The Influence of Malnutrition Measured by Hypalbuminemia and Body Mass Index on the Outcome of Geriatric Patients with a Fracture of the Proximal Femur. Medicina (B Aires) 2022; 58:medicina58111610. [PMID: 36363567 PMCID: PMC9698526 DOI: 10.3390/medicina58111610] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Objectives: Fractures of the proximal femur are a life-changing and life-threatening event for older people. Concomitant malnutrition has been described as an independent risk factor for complications and mortality. Therefore, we examined the influence of albumin and body mass index (BMI) as parameters for the nutritional state on the outcome after geriatric hip fracture surgery. Materials and Methods: Data were retrospectively collected from hospital information systems, and complications and all other parameters were obtained from patient charts. We included patients aged 70 years or above with a fracture of the proximal femur. We excluded periprosthetic and peri-implant fractures and patients with a missing BMI or albumin value. Results: Patients with a BMI below 20 kg/m2 were more likely to be female but did not differ from the normal BMI group in terms of baseline parameters. Patients with hypoalbuminemia had a higher ASA grade and Charlson Comorbidity Index, as well as a lower hemoglobin value and prothrombin time compared to those with normal albumin values and low BMI. Hypoalbuminemia was associated with significantly increased rates of complications (57.9% vs. 46.7%, p = 0.04) and mortality (10.3% vs. 4.1%, p = 0.02). Blood loss and transfusion rates were higher in the hypoalbuminemia group. Patients with a BMI below 20 kg/m2 had a higher risk of intraoperative cardiac arrest (2.6% vs. 0.4%, p = 0.05) but did not show higher mortality rates than patients with a BMI above 20 kg/m2. However, the outcome parameter could not be confirmed in the regression analysis. Conclusions: Hypoalbuminemia might be an indicator for more vulnerable patients with a compromised hemoglobin value, prothrombin time, and ASA grade. Therefore, it is also associated with higher mortality and postoperative complications. However, hypoalbuminemia was not an independent predictor for mortality or postoperative complications, but low albumin values were associated with a higher CCI and ASA grade than in patients with a BMI below 20 kg/m2.
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Affiliation(s)
- Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Fahd Malek
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Moritz Rommelmann
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, 35043 Marburg, Germany
| | - Tom Knauf
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, 35043 Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, 35043 Marburg, Germany
| | - Bjoern Hussmann
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Alexander Maslaris
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276 Essen, Germany
- Correspondence:
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Aigner R, Buecking B, Hack J, Schwenzfeur R, Eschbach D, Einheuser J, Schoeneberg C, Pass B, Ruchholtz S, Knauf T. Effect of Direct Oral Anticoagulants on Treatment of Geriatric Hip Fracture Patients: An Analysis of 15,099 Patients of the AltersTraumaRegister DGU®. Medicina (B Aires) 2022; 58:medicina58030379. [PMID: 35334555 PMCID: PMC8951459 DOI: 10.3390/medicina58030379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The increased use of direct oral anticoagulants (DOACs) results in an increased prevalence of DOAC treatment in hip fractures patients. However, the impact of DOAC treatment on perioperative management of hip fracture patients is limited. In this study, we describe the prevalence of DOAC treatment in a population of hip fracture patients and compare these patients with patients taking vitamin K antagonists (VKA) and patients not taking anticoagulants. Materials and Methods: This study is a retrospective analysis from the Registry for Geriatric Trauma (ATR-DGU). The data were collected prospectively from patients with proximal femur fractures treated between January 2016 and December 2018. Among other factors, anticoagulation was surveyed. The primary outcome parameter was time-to-surgery. Further parameters were: type of anesthesia, surgical complications, soft tissue complications, length of stay and mortality. Results: In total, 11% (n = 1595) of patients took DOACs at the time of fracture, whereas 9.2% (n = 1325) were on VKA therapy. During the study period, there was a shift from VKA to DOACs. The time-to-surgery of patients on DOACs and of patients on VKA was longer compared to patients who did not take any anticoagulation. No significant differences with regard to complications, type of anesthesia and mortality were found between patients on DOACs compared to VKA treatment. Conclusion: An increased time-to-surgery in patients taking DOACs and taking VKA compared to non-anticoagulated patients was found. This underlines the need for standardized multi-disciplinary orthopedic, hematologic and ortho-geriatric algorithms for the management of hip fracture patients under DOAC treatment. In addition, no significant differences regarding complications and mortality were found between DOAC and VKA users. This demonstrates that even in the absence of widely available antidotes, the safe management of geriatric patients under DOACs with proximal femur fractures is possible.
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Affiliation(s)
- Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
| | - Benjamin Buecking
- Department for Trauma Surgery, Klinikum Hochsauerland, 59821 Arnsberg, Germany;
| | - Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
| | - Ruth Schwenzfeur
- Working Committee on Geriatric Trauma Registry of the German Trauma Society, 80538 München, Germany;
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
| | - Jakob Einheuser
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45131 Essen, Germany; (C.S.); (B.P.)
| | - Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45131 Essen, Germany; (C.S.); (B.P.)
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
| | - Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (R.A.); (J.H.); (D.E.); (J.E.); (S.R.)
- Correspondence: ; Tel.: +49-6421-58-63174; Fax: +49-6421-58-66721
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Knauf T, Buecking B, Geiger L, Hack J, Schwenzfeur R, Knobe M, Eschbach D, Ruchholtz S, Aigner R. The Predictive Value of the “Identification of Seniors at Risk” Score on Mortality, Length of Stay, Mobility and the Destination of Discharge of Geriatric Hip Fracture Patients. Clin Interv Aging 2022; 17:309-316. [PMID: 35386750 PMCID: PMC8979564 DOI: 10.2147/cia.s344689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The German Society for Geriatrics recommends the “ISAR” questionnaire as a screening tool for patients ≥70 for geriatric screening in emergency rooms. Although the ISAR-score is collected routinely in the “AltersTraumaRegister DGU®” (ATR-DGU), to date less is known about the predictive value of the “ISAR”-score in geriatric trauma patients. Patients and Methods Currently, 84 clinics participate in the ATR-DGU. This evaluation is limited to the subgroup of proximal femur fractures from 2016–2018. Patients ≥70 years, who underwent surgery for a hip fracture are included in the ATR-DGU. In this evaluation, the influence of the “ISAR”-score on mortality, length of stay, mobility and the destination of discharge was examined. Results Overall 10,098 patients were included in the present study. The median age was 85 years (interquartile range (IQ) 80–89 years). According to the ISAR-score 80.6% (n=8142) of the patients were classified as geriatric patients (cut off “ISAR”-score ≥2 points). These group of patients had a length of stay of 16 days (IQ10.1–22.1) compared to the non-geriatric patient cohort showing a length of stay of 15 days (IQ10.1–20.1). Patients showing an ISAR-score ≥2 had an increased risk of being discharged to a nursing home (OR 8.25), not being able to walk (OR 12.52) and higher risk of mortality (OR 3.45). Conclusion The “ISAR”-score shows predictive power for the length of stay, mobility, hospital mortality and discharge after hospital in the collective of geriatric trauma patients. It therefore seems suitable as a screening tool for geriatric trauma patients in the emergency department and should be considered in this context.
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Affiliation(s)
- Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
- Correspondence: Tom Knauf, Tel +49-6421-58-63174, Fax +49-6421-58-66721, Email
| | - Benjamin Buecking
- Department for Trauma Surgery, Klinikum Hochsauerland, Arnsberg, Germany
| | - Lukas Geiger
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Ruth Schwenzfeur
- Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), München, Germany
| | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
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Koenig A, Akgöl A, Verbe J, Aigner R, Fiebich M, Thomas R, Mahnken A. Joint replacement increases radiation exposure to the staff in angiography: a phantom study. Eur J Radiol 2022; 151:110270. [DOI: 10.1016/j.ejrad.2022.110270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
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Pass B, Vajna E, Knauf T, Rascher K, Aigner R, Eschbach D, Lendemans S, Knobe M, Schoeneberg C. COVID-19 and Proximal Femur Fracture in Older Adults-A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU). J Am Med Dir Assoc 2021; 23:576-580. [PMID: 34678268 PMCID: PMC8487770 DOI: 10.1016/j.jamda.2021.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022]
Abstract
Objectives COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate the impact of a COVID-19 infection in patients with a proximal femur fracture not only on mortality but also on quality of life (QoL), length of stay, and discharge target. Design Retrospective cohort analysis from July 1, 2020, to December 31, 2020. The Registry for Geriatric Trauma collected the data prospectively. Patient groups with and without COVID-19 infection were compared using linear and logistic regression models. Setting and Participants Retrospective multicenter registry study including patients aged ≥70 years with proximal femur fracture requiring surgery from 107 certified Centers for Geriatric Trauma in Germany, Austria, and Switzerland. Measures The occurrence and impact of COVID-19 infection in patients suffering a proximal femur fracture were measured regarding in-house mortality, length of stay, and discharge location. Moreover, QoL was measured by the validated EQ-5D-3L questionnaire. Results A total of 3733 patients were included in our study. Of them, 123 patients tested COVID-19 positive at admission. A COVID-19 infection resulted in a 5.95-fold higher mortality risk (odds ratio 5.95, P < .001], a length of stay prolonged by 4.21 days [regression coefficient (β) 4.21, P < .001], a reduced QoL (β −0.13, P = .001), and a change in discharge target, more likely to their home instead of another inpatient facility like a rehabilitation clinic (P = .013). Conclusions and Implications The impact of a COVID-19 infection in patients suffering a proximal femur fracture is tremendous. The infected patients presented a dramatic rise in mortality rate, were significantly less likely to be discharged to a rehabilitation facility, had a longer in-hospital stay, and a reduced QoL.
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Affiliation(s)
- Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Elvira Vajna
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Tom Knauf
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | | | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany
| | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
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- Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), Berlin, Germany
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Schoeneberg C, Pass B, Oberkircher L, Rascher K, Knobe M, Neuerburg C, Lendemans S, Aigner R. Impact of concomitant injuries in geriatric patients with proximal femur fracture : an analysis of the Registry for Geriatric Trauma. Bone Joint J 2021; 103-B:1526-1533. [PMID: 34465160 DOI: 10.1302/0301-620x.103b9.bjj-2021-0358.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The impact of concomitant injuries in patients with proximal femoral fractures has rarely been studied. To date, the few studies published have been mostly single-centre research focusing on the influence of upper limb fractures. A retrospective cohort analysis was, therefore, conducted to identify the impact and distribution of concomitant injuries in patients with proximal femoral fractures. METHODS A retrospective, multicentre registry-based study was undertaken. Between 1 January 2016 and 31 December 2019, data for 24,919 patients from 100 hospitals were collected in the Registry for Geriatric Trauma. This information was queried and patient groups with and without concomitant injury were compared using linear and logistic regression models. In addition, we analyzed the influence of the different types of additional injuries. RESULTS A total of 22,602 patients met the inclusion criteria. The overall prevalence of a concomitant injury was 8.2% with a predominance of female patients (8.7% vs 6.9%; p < 0.001). Most common were fractures of the ipsilateral upper limb. Concomitant injuries resulted in prolonged time-to-surgery (by 3.4 hours (95 confidence interval (CI) 2.14 to 4.69)) and extended length of stay in hospital by 2.2 days (95% CI 1.74 to 2.61). Mortality during the admission was significantly higher in the concomitant injury group (7.4% vs 5.3%; p < 0.001). Additionally, walking ability and quality of life were reduced in these patients at discharge. More patients were discharged to a nursing home instead of their own home compared to patients without additional injuries (25.8% vs 30.3%; p < 0.001). CONCLUSION With a prevalence of 8.2%, the appearance of a concomitant injury is common in elderly patients with hip fracture. These patients are at a greater risk for death during the admission, longer hospital stays, and delayed surgery. This knowledge is clinically important for all who are involved in the treatment of proximal femur fractures. Cite this article: Bone Joint J 2021;103-B(9):1526-1533.
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Affiliation(s)
- Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Klinikum Essen, Essen, Germany
| | - Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Klinikum Essen, Essen, Germany
| | - Ludwig Oberkircher
- Center for Orthopaedic and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | | | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Carl Neuerburg
- Department of General, Trauma and Reconstructive Surgery, Ludwigs-Maximilians-University, Munich, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Klinikum Essen, Essen, Germany
| | - Rene Aigner
- Center for Orthopaedic and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
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Marks L, Pass B, Knobe M, Volland R, Eschbach D, Lendemans S, Aigner R, Schoeneberg C. Quality of life, walking ability and change of living situation after trochanteric femur fracture in geriatric patients-Comparison between sliding hip screw and cephalomedullary nails from the registry for geriatric trauma. Injury 2021; 52:1793-1800. [PMID: 34039468 DOI: 10.1016/j.injury.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is no well-established gold standard for treating trochanteric femur fractures in the elderly. The two common treatment options are cephalomedullary nails (CMN) and sliding hip screws (SHS). In this study, treatment using CMN and SHS were compared for a cohort of patients older than 70 years of age: The main outcomes were quality of life and main residence after surgery. METHODS In this retrospective study we analyzed 24,919 patients from 100 hospitals, treated between 2016 and 2019 and documented in the Registry for Geriatric Trauma. The impact of CMN vs. SHS on the walking ability, quality of life (QoL), living situation, mortality, and revision rate were analyzed. To analyze the change of the living situation, the main residence 120 days after surgery for patients, who lived in their own home before fracture, was described for both groups. FINDINGS A total of 10,995 patients could be included of which 10,436 patients were treated with CMN and 369 patients with SHS. 120 days postoperative the QoL differed significantly (p = 0.020) in favor of treatment using CMN. 26% of the SHS group who lived at home prior to surgery had to reside in a nursing home after surgery, whereas the rate was only 18% in the CMN group (p < 0.001). No significant difference in the mortality rate nor a difference in the walking ability 120 days postoperative were found. CMN were implanted more promptly (median: 13.9 vs. 18.4 hours; p < 0,001). No differences were found concerning the revision rate between the two groups, neither during inpatient treatment (p = 0.723) nor during the 120 day follow-up period (p = 0.524). INTERPRETATION There might be a benefit for geriatric patients with trochanteric femur fractures to be treated with a proximal femur nail in regard to a higher QoL and a reduced institutionalization rate. Mortality or revision rate was not affected by the chosen implant.
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Affiliation(s)
- L Marks
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - B Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - M Knobe
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
| | - R Volland
- AUC - Academy for Trauma Surgery, Munich, Germany.
| | - D Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - S Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - R Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - C Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
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- Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), Berlin, Germany
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Knauf T, Eschbach D, Buecking B, Knobe M, Barthel J, Rascher K, Ruchholtz S, Aigner R, Schoeneberg C. Open Reduction in Subtrochanteric Femur Fractures Is Not Accompanied by a Higher Rate of Complications. ACTA ACUST UNITED AC 2021; 57:medicina57070659. [PMID: 34199013 PMCID: PMC8305416 DOI: 10.3390/medicina57070659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022]
Abstract
Backgroundand Objectives: Hip fractures are among the most typical geriatric fractures. Subtrochanteric fractures are considered difficult to treat, and, to date, there is no consensus on the optimal surgical treatment. Materialisand Methods: We analyzed data from the Registry for Geriatric Trauma, which includes patients ≥ 70 years old with hip fractures or periprosthetic fractures requiring surgery (21,734 patients in 2017-2019). For this study, we analyzed only the subgroup of patients with a subtrochanteric fracture. We analyzed the difference between closed and open surgical methods on a range of outcomes, including mortality, mobility, length of acute hospital stay, and the need for surgical revisions. Results: A total of 506 patients with subtrochanteric fractures were analyzed in this study. The median age was 85 years (interquartile range of 81-89). About 21.1% (n = 107) were operated on with a closed technique, 73.3% (n = 371) with open reduction without using a cerclage, and 5.53% (n = 28) with open reduction with the additional use of one or more cerclage wires. A total of 3.56% (n = 18) of the patients had complications requiring operative revision, most commonly soft tissue interventions (open vs. closed reduction-3.26% vs. 4.67%) (p = 0.687). Patients treated with open reduction were significantly more mobile 7 days after surgery (p = 0.008), while no significant effects on mortality (p = 0.312), length of hospital stay (p = 0.968), or surgical complications (p = 0.687) were found. Conclusion: Proper reduction is the gold standard practice for successful union in subtrochanteric fractures. This study shows that open reduction is not associated with a higher complication rate but does lead to increased mobility 7 days after operation. Therefore, in case of doubt, a good reduction should be aimed for, even using open techniques.
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Affiliation(s)
- Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (D.E.); (J.B.); (S.R.); (R.A.)
- Correspondence: ; Tel.: +49-6421-58-63174; Fax: +49-6421-58-66721
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (D.E.); (J.B.); (S.R.); (R.A.)
| | - Benjamin Buecking
- Center for Orthopaedics and Trauma Surgery, DRK-Kliniken Nordhessen, 34121 Kassel, Germany;
| | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, 6004 Lucerne, Switzerland;
| | - Juliane Barthel
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (D.E.); (J.B.); (S.R.); (R.A.)
| | | | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (D.E.); (J.B.); (S.R.); (R.A.)
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35039 Marburg, Germany; (D.E.); (J.B.); (S.R.); (R.A.)
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45131 Essen, Germany;
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Schoeneberg C, Pass B, Volland R, Knobe M, Eschbach D, Ketter V, Lendemans S, Aigner R. Four-month outcome after proximal femur fractures and influence of early geriatric rehabilitation: data from the German Centres of Geriatric Trauma DGU. Arch Osteoporos 2021; 16:68. [PMID: 33846869 DOI: 10.1007/s11657-021-00930-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/16/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study analyzed the outcome of orthogeriatric patients with hip fracture 4 months after surgery. The overall mortality rate was 12.2%. Sixty-five percent presented a degradation in walking ability, and 16% had to move to a nursing home. Early geriatric rehabilitation reduces the mortality rate and increases the rate of anti-osteoporotic treatment. PURPOSE Hip fractures are increasingly common with severe consequences. Therefore, the German Trauma Society (DGU) implemented an orthogeriatric co-management and developed the concept for certified Centre for Geriatric Trauma DGU. The patients' treatment data and the optional 120 days of follow-up were collected in the Registry for Geriatric Trauma DGU (ATR-DGU). This study analyzed these 4-month treatment results. METHODS A retrospective analysis of the ATR-DGU was conducted. Outcome parameters were the rate of readmission, rate of re-surgery, anti-osteoporotic therapy, housing, mortality, walking ability, and quality of life (QoL) 120 days post-surgery. The influence of the early geriatric rehabilitation (EGR) was evaluated using a regression analysis. RESULTS The follow-up data from 9780 patients were included. After 120 days, the mortality rate was 12.2%, the readmission rate 4%, and the re-surgery rate 3%. The anti-osteoporotic treatment increased from 20% at admission to 32%; 65% of the patients had a degradation in walking ability, and 16% of the patients who lived in their domestic environment pre-surgery had to move to a nursing home. QoL was distinctly reduced. The EGR showed a positive influence of anti-osteoporotic treatment (p<0.001) and mortality (p=0.011) but led to a slight reduction in QoL (p=0.026). CONCLUSION The 4-month treatment results of the ATR-DGU are comparable to international studies. The EGR led to a significant rise in anti-osteoporotic treatment and a reduction in mortality with a slight reduction in QoL.
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Affiliation(s)
- Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
| | - Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany
| | - Ruth Volland
- AUC, Academy for Trauma Surgery GmbH, Munich, Germany
| | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Vanessa Ketter
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
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Schoeneberg C, Aigner R, Pass B, Volland R, Eschbach D, Peiris SE, Ruchholtz S, Lendemans S. Effect of time-to-surgery on in-house mortality during orthogeriatric treatment following hip fracture: A retrospective analysis of prospectively collected data from 16,236 patients of the AltersTraumaRegister DGU®. Injury 2021; 52:554-561. [PMID: 32951920 DOI: 10.1016/j.injury.2020.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Time-to-surgery in geriatric hip fractures remains of interest. The majority of the literature reports a significantly decreased mortality rate after early surgery. Nevertheless, there are some studies presenting no effect of time-to-surgery on mortality. The body of literature addressing the effect of an orthogeriatric co-management is growing. Here we investigate the effect of time-to-surgery on in-house mortality in a group of patients treated under the best possible conditions in certified orthogeriatric treatment units. METHODS We conducted a retrospective cohort registry analysis from prospectively collected data of the AltersTraumaRegister DGU®. Data were analyzed univariably, and the association of early surgery with in-house mortality was assessed with multivariable logistic regression while controlling for specified patient characteristics. Additionally, propensity score matching for time-to-surgery was applied to examine its effect on the in-house mortality rate. FINDINGS A total of 15,099 patients met the inclusion criteria. The median age was 85 years (IQR 80-89), and 72.1% were female. The overall in-house mortality rate was 5.5%. Most (71.2%) of the patients were treated within 24 h, and 91.6% within 48 h. Neither the multivariable logistic regression model nor the propensity score matching indicated that early surgery was associated with a decreased mortality rate. The most important indicators for mortality were ASA ≥ 3 [Odds ratio (OR) 3.4, 95% confidence interval (CI) 2.35-5.11], fracture event during inpatient stay (OR 2.6, 95% CI 1.48-4.3), ISAR ≥ 2 (OR 1.88, 95% CI 1.33-2.76), and male gender (OR 1.71, 95% CI 1.39-2.09). INTERPRETATION Our results suggest that for those patients, who were treated in an orthogeriatric co-management under the best possible conditions, there are no significant differences regarding in-house mortality rate between the time-to-surgery intervals of 24 and 48 h or slightly above. This and the comparatively small number of patients who underwent surgery after 24 h show that an extension of the pre-surgery interval, justified by an orthogeriatric treatment team, will not be detrimental to the affected patients.
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Affiliation(s)
- Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
| | - Ruth Volland
- AUC, Akademie der Unfallchirurgie GmbH, Munich, Germany.
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | | | - Steffen Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany.
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- Working Committee on Geriatric Trauma Registry (AK ATR) of the German Trauma Society (DGU), Berlin, Germany
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Knauf T, Jensen KO, Hack J, Barthel J, Althaus H, Buecking B, Aigner R, Knobe M, Ruchholtz S, Eschbach D. Type of underlying fracture after the surgical treatment of geriatric trauma patients has no effect on mortality during intensive care treatment. Geriatr Gerontol Int 2020; 20:1120-1125. [PMID: 33155420 DOI: 10.1111/ggi.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/23/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
AIM Due to demographic change, the number of geriatric patients is still rising. Although hip fractures are the subject of current research, little is known about the remaining geriatric trauma entities. The aim of this study was to collect data of the age-related traumatological intensive care unit (ICU) population, its underlying diagnosis, and the influence on mortality and length of stay in the ICU. METHODS Geriatric trauma patients (aged ≥65 years) treated postoperatively in our surgical ICU were included in this retrospective observational study covering the period 2013-2017. In addition to the underlying fracture entities, patient characteristics, such as age, sex, Charlson Comorbidity Index, length of stay and mortality, were collected to identify possible independent predictive factors for mortality in the ICU using multivariate analysis. RESULTS During the observation period, 805 (60.5%) patients met the inclusion criteria. 47.6% of the patients suffered from a proximal femoral fracture. The total mortality rate during the stay in the ICU was 7.5%. Significant predictive factors for mortality in the ICU were Charlson Comorbidity Index (P < 0.001) and length of stay (P < 0.001). The different fracture types themselves were not a significant risk factor for mortality (P = 0.862). CONCLUSION Patients with proximal femoral fractures account for approximately half of the patients in intensive care. The mortality rate of these patients is no higher than that in geriatric trauma patients with other fractures. The progression is essentially influenced by the patient's comorbidities. Nowadays, the focus shifts from trauma care to the therapy of concomitant diseases. Nevertheless, this cohort, when adequately treated, shows a comparatively low mortality rate. Geriatr Gerontol Int 2020; 20: 1120-1125.
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Affiliation(s)
- Tom Knauf
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Kai Oliver Jensen
- Center of Trauma Surgery, University Hospital Zuerich, Zürich, Switzerland
| | - Juliana Hack
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Juliane Barthel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Hannah Althaus
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopedics and Trauma Surgery, DRK-Kliniken Nordhessen, Kassel, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Matthias Knobe
- Department of Orthopedic Trauma, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Steffen Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
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Knauf T, Hack J, Barthel J, Eschbach D, Schoeneberg C, Ruchholtz S, Buecking B, Aigner R. Medical and economic consequences of perioperative complications in older hip fracture patients. Arch Osteoporos 2020; 15:174. [PMID: 33157555 PMCID: PMC7647988 DOI: 10.1007/s11657-020-00843-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
UNLABELLED Patients suffering from complications during inpatient treatment after hip fracture surgery are associated with a worse mid-term outcome. While surgically treatable complications only delay the healing process, internal complications seem to worsen the outcome in the long run. All complications come with significant increased costs during the hospital stay. PURPOSE Due to the demographic changes, the importance of hip fractures is still increasing nowadays. Not only surgical but also medical complications represent a major challenge in the treatment of those patients. Nevertheless, only few is known about the functional, medical, and economic consequences of complications. METHODS A total of 402 hip fracture patients ≥ 60 years were observed prospectively at a German university hospital. Complications were assessed during the inpatient stay and classified by Clavien and Dindo. Afterwards their influence on acute care costs was examined as well as their influence on the mortality, health-related quality of life (HRQL) (EQ5D), functional capacities (Barthel index), and mobility (Tinetti score) in the follow-up periods of 6 and 12 months. RESULTS Complications that required surgical revision/treatment (type III) were associated with an increased 6 months' mortality, while type II and IV complications did not influence mortality after 6 and 12 months. Six months after surgery, HRQL, Barthel score, and Tinetti score were reduced in patients suffering from all different types of complications. After 12 months however, HRQL, Barthel score, and Tinetti score following type II and IV complications remained reduced, while the scores improved in patients suffering from type III complication. All types of complications led to significantly increased acute care costs. CONCLUSIONS The results of the present study emphasize the crucial role of perioperative complications in older patients with hip fractures. Therefore, special attention has to be given to the prevention of those complications, e.g., with orthogeriatric treatment models, which have been shown to be effective in the reduction of complications.
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Affiliation(s)
- Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany.
| | - Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany
| | - Juliane Barthel
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany
| | - Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Alfried-Krupp-Straße 21, 45131, Essen, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopaedics and Trauma Surgery, DRK-Kliniken Nordhessen, Hansteinstraße 29, 34121, Kassel, Germany
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstraße 1, 35043, Marburg, Germany
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Hack J, Buecking B, Aigner R, Oberkircher L, Knauf T, Ruchholtz S, Eschbach D. What are the influencing factors in self-rated health status after hip fracture? A prospective study on 402 patients. Arch Osteoporos 2019; 14:92. [PMID: 31435743 DOI: 10.1007/s11657-019-0642-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/12/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Health status (HS) and influencing factors in HS were evaluated six and 12 months after hip fracture. One-third of the patients did not reach their pre-fracture HS within 1 year. HS before fracture and fall risk could, inter alia, be identified as influencing factors. PURPOSE From a patient's perspective, regaining pre-fracture health status (HS) is one of the most important factors concerning the outcome after hip fracture. The aim of this study was to evaluate the HS and particularly to identify influencing factors in HS 6 and 12 months after hip fracture. METHODS A total of 402 patients with hip fractures aged 60 years and older were included. HS was evaluated using the EQ-5D questionnaire pre-fracture and at 6 and 12 months after surgery. Multivariate regression analysis was performed to identify influencing factors in HS at 6 and 12 months. Afterwards, the results in the EQ-5D index were dichotomized into worse and equal/better results than before fracture, and a multivariate logistic regression analysis was performed for the dichotomized variables at 6 and 12 months. RESULTS The EQ-5D index decreased from 0.71 before the fracture to 0.60 at 6 months (p < 0.001) and increased slightly to 0.63 at 12 months (p = 0.328). A high pre-fracture EQ-5D index was associated with not reaching the pre-fracture EQ-5D index, and a high Tinetti score at hospital discharge was associated with reaching the pre-fracture EQ-5D index at 6 and 12 months. A high ASA score was an influencing factor behind a lower EQ-5D index than before the fracture at 6 months. CONCLUSIONS Hip fractures constitute a deep and long-lasting drop in the patients' HS. Early and intensive physiotherapy and individualized rehabilitation programmes regarding a patient's living situation before the fracture seem to be essential to improve HS.
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Affiliation(s)
- Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany.
| | - Benjamin Buecking
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Ludwig Oberkircher
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Tom Knauf
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
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Knauf T, Buecking B, Hack J, Barthel J, Bliemel C, Aigner R, Ruchholtz S, Eschbach D. Development of the Barthel Index 5 years after hip fracture: Results of a prospective study. Geriatr Gerontol Int 2019; 19:809-814. [PMID: 31264331 DOI: 10.1111/ggi.13723] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/21/2019] [Accepted: 05/26/2019] [Indexed: 12/12/2022]
Abstract
AIM The importance of proximal femoral fractures is increasing due to demographic change. Despite appropriate care, these are associated with poor results. We are still lagging behind, and require information on the long-term functional outcome of these patients and the predictive factors involved. METHODS Between 2009 and 2011, 402 patients aged >60 years with hip fractures were included in this prospective observational study. Patients were assessed with the Barthel Index before fracture, at discharge, and 6 months, 1 year and 5 years after surgery. In addition, a variety of parameters (sex, age, fracture type, American Society of Anesthesiologists classification, Mini-Mental State Examination, housing situation, occurrence of complications during inpatient stay and type of care) were collected to identify the possible independent predictive factors using multivariate analysis. RESULTS The lowest Barthel Index was found at discharge (66 ± 24) for patients from an acute hospital. The Barthel Index improved within the first 6 months (86 ± 21) and decreased afterwards. The factors associated with a significantly higher point loss of the Barthel Index in the multivariate analysis were age (P-value 0.020), pre-fracture Barthel Index, (P ≤ 0.001), Mini-Mental State Examination (P ≤ 0.001) and type II complications (P = 0.001). The other values showed no significant influence on the Barthel Index. CONCLUSIONS The present results showed that patients after a hip fracture have a great rehabilitation potential within the first 6 months after the event. More attention should be paid to type II complications and the occurrence of cognitive impairment. Both seem to be a surrogate parameter for the frailty of the patients. Geriatr Gerontol Int 2019; 19: 809-814.
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Affiliation(s)
- Tom Knauf
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Juliana Hack
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Juliane Barthel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Christopher Bliemel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
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Bockmann B, Lechler P, Boese CK, Aigner R, Ruchholtz S, Frink M. Risk factors for secondary displacement in conservatively treated isolated greater tuberosity fractures: An analysis of 82 cases. Orthop Traumatol Surg Res 2019; 105:317-322. [PMID: 30635230 DOI: 10.1016/j.otsr.2018.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 06/02/2018] [Accepted: 06/29/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The optimal treatment of isolated fractures of the greater tuberosity is an important topic of current surgical research. While non-displaced fractures are amenable to conservative treatment, displacement of the fragment can result in rotator cuff malfunction and impingement. For the present study, risk factors predicting secondary fragment displacement were analyzed. HYPOTHESIS Certain risk factors determine a higher risk of secondary displacement in patients with greater tuberosity fractures. PATIENTS AND METHODS All patients diagnosed with a fracture of the greater tuberosity and initially treated non-surgically at our Level I trauma center between January 2008 and July 2015 were included in this retrospective analysis. Patients were grouped into: no secondary displacement (group 1) and secondary displacement at follow-up (group 2). The following risk factors were analyzed: age, gender, side of fracture, initial displacement, fragment/head ratio, fragment shape, dislocation, concomitant fractures and concomitant fractures to the same extremity. RESULTS 82 patients (42 male, 40 female) were eligible for further analyses. Median follow-up was 8.0±39.5 days. Patients with secondary displacement (group 2) were significantly older (group 1: 51.7±15.5, group 2: 68.3±14.3; p<0.001) and had significantly more shoulder dislocations (p=0.024), whereas gender (p=0.299), side of fracture (p=0.189) and fragment/head ratio (p=0.660) showed no significant different distribution between both groups. Finally, split-type fractures increased the risk of secondary displacement. DISCUSSION The present study identified age older than 65 years to be an important risk factor for secondary displacement in the conservative management of fractures of the greater tuberosity. Furthermore, fracture type and shoulder dislocations are factors associated with an increased relative risk for secondary displacement. LEVEL OF PROOF III, Retrospective comparative study.
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Affiliation(s)
- Benjamin Bockmann
- Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, 44791 Bochum, Germany
| | - Philipp Lechler
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - Christoph Kolja Boese
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Kerpener Straße 62, Cologne, Germany
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - Michael Frink
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
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20
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Kurch L, Hasenclever D, Kluge R, Georgi T, Tchavdarova L, Golombeck M, Sabri O, Eggert A, Brenner W, Sykora KW, Bengel FM, Rossig C, Körholz D, Schäfers M, Feuchtinger T, Bartenstein P, Ammann RA, Krause T, Urban C, Aigner R, Gattenlöhner S, Klapper W, Mauz-Körholz C. Only strongly enhanced residual FDG uptake in early response PET (Deauville 5 or qPET ≥ 2) is prognostic in pediatric Hodgkin lymphoma: Results of the GPOH-HD2002 trial. Pediatr Blood Cancer 2019; 66:e27539. [PMID: 30426671 DOI: 10.1002/pbc.27539] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/11/2018] [Accepted: 10/14/2018] [Indexed: 11/06/2022]
Abstract
PURPOSE In 2014, we published the qPET method to quantify fluorodeoxyglucose positron emission tomography (FDG-PET) responses. Analysis of the distribution of the quantified signals suggested that a clearly abnormal FDG-PET response corresponds to a visual Deauville score (vDS) of 5 and high qPET values ≥ 2. Evaluation in long-term outcome data is still pending. Therefore, we analyzed progression-free survival (PFS) by early FDG-PET response in a subset of the GPOH-HD2002 trial for pediatric Hodgkin lymphoma (PHL). PATIENTS/METHODS Pairwise FDG-PET scans for initial staging and early response assessment after two cycles of chemotherapy were available in 93 PHL patients. vDS and qPET measurement were performed and related to PFS. RESULTS Patients with a qPET value ≥ 2.0 or vDS of 5 had 5-year PFS rates of 44%, respectively 50%. Those with qPET values < 2.0 or vDS 1 to 4 had 5-year PFS rates of 90%, respectively 80%. The positive predictive value of FDG-PET response assessment increased from 18% (9%; 33%) using a qPET threshold of 0.95 (vDS ≤ 3) to 30% (13%; 54%) for a qPET threshold of 1.3 (vDS ≤ 4) and to 56% (23%; 85%) when the qPET threshold was ≥ 2.0 (vDS 5). The negative predictive values remained stable at ≥92% (CI: 82%; 98%). CONCLUSION Only strongly enhanced residual FDG uptake in early response PET (vDS 5 or qPET ≥ 2, respectively) seems to be markedly prognostic in PHL when treatment according to the GPOH-HD-2002 protocol is given.
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Affiliation(s)
- L Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - D Hasenclever
- Institute of Medical Statistics, Informatics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - R Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - T Georgi
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - L Tchavdarova
- Clinic of Nuclear Medicine, National Hospital for Active Treatment in Oncology, Sofia, Bulgaria
| | - M Golombeck
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - A Eggert
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Charité Berlin, Berlin, Germany
| | - W Brenner
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K W Sykora
- Department of Pediatric Hematology and Oncology, Medizinische Hochschule Hannover, Hannover, Germany
| | - F M Bengel
- Department of Nuclear Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - C Rossig
- University Children's Hospital Münster, Pediatric Hematology and Oncology, Münster, Germany
| | - D Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Giessen, Germany
| | - M Schäfers
- Department of Nuclear Medicine, University Hospital of Münster, Münster, Germany
| | - T Feuchtinger
- Dr. von Hauner University Children's Hospital, LMU Munich, Munich, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, LMU Munich, Munich, Germany
| | - R A Ammann
- Division of Pediatric Hematology and Oncology, Department of Pediatrics (Inselspital) Bern University Hospital, University of Bern, Bern, Switzerland
| | - T Krause
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Urban
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Graz, Graz, Austria
| | - R Aigner
- Department of Radiology, Medical University Graz, Graz, Austria
| | - S Gattenlöhner
- Department of Pathology, Justus-Liebig University of Giessen, Giessen, Germany
| | - W Klapper
- Department of Pathology, University Hospital of Kiel, Kiel, Germany
| | - C Mauz-Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Giessen, Germany.,Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
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Barthel J, Fischer M, Aigner R, Hack J, Bücking B, Ruchholtz S, Eschbach D. Erfassung von Mangelernährung bei geriatrischen Traumapatienten. Unfallchirurg 2019; 122:864-869. [DOI: 10.1007/s00113-018-0595-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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22
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Hack J, Krüger A, Masaeli A, Aigner R, Ruchholtz S, Oberkircher L. Cement-augmented sacroiliac screw fixation with cannulated versus perforated screws - A biomechanical study in an osteoporotic hemipelvis model. Injury 2018; 49:1520-1525. [PMID: 29914671 DOI: 10.1016/j.injury.2018.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/16/2018] [Accepted: 06/08/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Cement-augmentation is a well-established way to improve the stability of sacroiliac screw fixation in osteoporosis-associated fragility fractures of the posterior pelvic ring. However, to date little is known about the influence of different techniques of cement augmentation on construct stability. The aim of this study was to evaluate the primary stability of cement-augmented sacroiliac screw fixation with cannulated versus perforated screws under cyclic loading. MATERIALS AND METHODS A total of eight fresh-frozen human cadaveric hemipelvis specimens with osteoporosis were used. After generating ventral osteotomies on both sides of the sacrum, each specimen was treated using a cement-augmented cannulated screw on one side and a cement-augmented perforated screw on the other side. Afterwards, axial cyclic loading was performed. RESULTS No statistically significant difference was found between cannulated and perforated screws concerning maximum load (356.25 N versus 368.75 N, p = 0.749), plastic deformation (1.95 mm versus 1.43 mm, p = 0.798) and stiffness (27.04 N/mm versus 40.40 N/mm, p = 0.645). CONCLUSIONS Considering the at least equivalent results for perforated screws, cement augmentation via perforated screws might be an interesting option in clinical practice because of potential advantages, e.g. radiological control before cement application, reduced risk of cement displacement and time saving.
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Affiliation(s)
- J Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - A Krüger
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany
| | - A Masaeli
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany
| | - R Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany
| | - S Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany
| | - L Oberkircher
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany
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23
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Eschbach D, Buecking B, Kivioja H, Fischer M, Wiesmann T, Zettl R, Oberkircher L, Barthel J, Aigner R, Ruchholtz S, Bliemel C. One year after proximal or distal periprosthetic fracture of the femur -two conditions with divergent outcomes? Injury 2018; 49:1176-1182. [PMID: 29729819 DOI: 10.1016/j.injury.2018.04.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/27/2018] [Accepted: 04/23/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility. METHODS Prospective single-centre observation study of periprosthetic femoral fractures with stable implants. Present subgroup analysis includes patients with PFTKA and PFTHA. All patients were treated with polyaxial angular stable plates using two standardized techniques: a minimally invasive percutaneous distal insertion technique and a mini-open technique. Data collection included implant- and operation-related information as well as demographics, clinical course, complications and return to pre-fracture mobility. Data were collected during a 12-month follow-up. RESULTS We were able to analyse the data of 73 patients. The PFTKA group had 37 patients with a mean age of 76 ± 10 years; 88% were female. After 1 year, 3 patients in this cohort had died; 68% of survivors had reached their pre-fracture mobility; 22% had undergone operative revisions for various reasons. The PFTHA cohort included 36 patients with a mean age of 80 ± 13 years, 72% were female. After 1 year, 9 patients had died in this cohort, 42% of survivors had reached their pre-fracture mobility. Non-operative complications occurred for 16% in the PFTKA group and 64% in the PFTHA group (p < 0.001). 11% had undergone operative revisions for various reasons, among them, two cases of nonunion but no primary infection. CONCLUSION On average, compared to the PFTHA patients, PFTKA patients were younger, underwent significantly lower rates of non-operative complications, had a tendency towards lower mortality, and returned to pre-fracture mobility at higher rates, although they tended to have more revisions when compared to treatment for PFTHA. Overall, when periprosthetic fractures of the femur were treated using polyaxial locking plate osteosynthesis, patients showed very low rates of nonunion and no primary infection.
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Affiliation(s)
- D Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
| | - B Buecking
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - H Kivioja
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - M Fischer
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - T Wiesmann
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Marburg, Germany
| | - R Zettl
- Department of Orthopaedic and Trauma Surgery, Kantonsspital Frauenfeld, 8500, Frauenfeld, Switzerland
| | - L Oberkircher
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - J Barthel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - R Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - S Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
| | - C Bliemel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany
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Hack J, Eschbach D, Aigner R, Oberkircher L, Ruchholtz S, Bliemel C, Buecking B. Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients-Results of a Prospective Observational Study. J Geriatr Psychiatry Neurol 2018; 31:84-89. [PMID: 29562811 DOI: 10.1177/0891988718760240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. METHODS A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. RESULTS Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. CONCLUSIONS In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.
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Affiliation(s)
- Juliana Hack
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Daphne Eschbach
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Rene Aigner
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Ludwig Oberkircher
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Steffen Ruchholtz
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Christopher Bliemel
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Benjamin Buecking
- 1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
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Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Teoh EJ, Bottomley D, Scarsbrook A, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Chau A, Ward P, Miller MP, Stevens DJ, Wilson L, Gleeson FV, Scheidhauer K, Seidl C, Autenrieth M, Bruchertseifer F, Apostolidis C, Kurtz F, Horn T, Pfob C, Schwaiger M, Gschwend J, D'Alessandria C, Morgenstern A, Uprimny C, Kroiss A, Decristoforo C, von Guggenberg E, Nilica B, Horninger W, Virgolini I, Rasul S, Poetsch N, Woehrer A, Preusser M, Mitterhauser M, Wadsak W, Widhalm G, Mischkulnig M, Hacker M, Traub-Weidinger T, Wright CL, Binzel K, Wuthrick EJ, Miller ED, Maniawski P, Zhang J, Knopp MV, Rep S, Hocevar M, Vaupotic J, Zdesar U, Zaletel K, Lezaic L, Mairinger S, Filip T, Sauberer M, Flunkert S, Wanek T, Stanek J, Okamura N, Langer O, Kuntner C, Fornito MC, Balzano R, Di Martino V, Cacciaguerra S, Russo G, Seifert D, Kleinova M, Cepa A, Ralis J, Hanc P, Lebeda O, Mosa M, Vandenberghe S, Mikhaylova E, Borys D, Viswanath V, Stockhoff M, Efthimiou N, Caribe P, Van Holen R, Karp JS, Binzel K, Zhang J, Wright CL, Maniawski P, Knopp MV, Haller PM, Farhan C, Piackova E, Jäger B, Knoll P, Kiss A, Podesser BK, Wojta J, Huber K, Mirzaei S, Traxl A, Komposch K, Glitzner E, Wanek T, Mairinger S, Sibilia M, Langer O, Fornito MC, Russello M, Russo G, Balzano R, Sorko S, Gallowitsch HJ, Kohlfuerst S, Matschnig S, Rieser M, Sorschag M, Lind P, Ležaič L, Rep S, Žibert J, Frelih N, Šuštar S, Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Baum RP, Langbein T, Singh A, Shahinfar M, Schuchardt C, Volk GF, Kulkarni HR, Fornito MC, Cacciaguerra S, Balzano R, Di Martino GV, Russo G, Thomson WH, Kudlacek M, Karik M, Farhan C, Rieger H, Pokieser W, Glaser K, Mirzaei S, Petz V, Tugendsam C, Buchinger W, Schmoll-Hauer B, Schenk IP, Rudolph K, Krebs M, Zettinig G, Zoufal V, Wanek T, Krohn M, Mairinger S, Stanek J, Sauberer M, Filip T, Pahnke J, Langer O, Weitzer F, Pernthaler B, Salamon S, Aigner R, Koranda P, Henzlová L, Kamínek M, Váchalová M, Bachleda P, Summer D, Garousi J, Oroujeni M, Mitran B, Andersson KG, Vorobyeva A, Löfblom JN, Orlova A, Tolmachev V, Decristoforo C, Kaeopookum P, Summer D, Orasch T, Lechner B, Petrik M, Novy Z, Rangger C, Haas H, Decristoforo C. Abstracts of the 33rd International Austrian Winter Symposium : Zell am See, Austria. 24-27 January 2018. EJNMMI Res 2018; 8:5. [PMID: 29362999 PMCID: PMC5780335 DOI: 10.1186/s13550-017-0354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E J Teoh
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Bottomley
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Scarsbrook
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Payne
- University College London, London, UK
| | - A Afaq
- University College London, London, UK
| | - J Bomanji
- University College London, London, UK
| | - N van As
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S Chua
- The Royal Marsden NHS Foundation Trust, London, UK
| | - P Hoskin
- Mount Vernon Cancer Centre, London, UK
| | | | - G J Cook
- King's College London, London, UK
| | | | - A Chau
- Blue Earth Diagnostics, Oxford, UK
| | - P Ward
- Blue Earth Diagnostics, Oxford, UK
| | | | | | - L Wilson
- Blue Earth Diagnostics, Oxford, UK
| | - F V Gleeson
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Scheidhauer
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - C Seidl
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Autenrieth
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | | | | | - F Kurtz
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - T Horn
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C Pfob
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Schwaiger
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - J Gschwend
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C D'Alessandria
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | | | - C Uprimny
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - A Kroiss
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - E von Guggenberg
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - B Nilica
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - W Horninger
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - I Virgolini
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - S Rasul
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - N Poetsch
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - A Woehrer
- Clinical Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Preusser
- Clinical University of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - G Widhalm
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Mischkulnig
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - T Traub-Weidinger
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - C L Wright
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - K Binzel
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - E J Wuthrick
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E D Miller
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - P Maniawski
- Clinical Science, Philips Healthcare, Cleveland, OH, USA
| | - J Zhang
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - Sebastijan Rep
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Hocevar
- Department of Oncological Surgery, Oncology Institute Ljubljana, Ljubljana, Slovenia
| | | | - Urban Zdesar
- Institute of Occupational Safety Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Luka Lezaic
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Mairinger
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Thomas Filip
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sauberer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Flunkert
- Neuropharmacology, QPS Austria GmbH, Grambach, Austria
| | - T Wanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Langer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C Kuntner
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - V Di Martino
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - S Cacciaguerra
- Pediatric Surgery Department Arnas Garibaldi Catania, Catania, Italy
| | - G Russo
- H. Pharmacy Department Arnas Garibaldi Catania, Catania, Italy
| | - D Seifert
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Kleinova
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - A Cepa
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - J Ralis
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - P Hanc
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - O Lebeda
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Mosa
- Charles university Faculty of Science Prague, Prague, Czech Republic
| | - S Vandenberghe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | | | - D Borys
- Silesian University of Technology Gliwice, Gliwice, Poland
| | - V Viswanath
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Stockhoff
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - N Efthimiou
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - P Caribe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - R Van Holen
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - J S Karp
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - P M Haller
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - C Farhan
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - E Piackova
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - B Jäger
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - P Knoll
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Kiss
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - B K Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - J Wojta
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - K Huber
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - S Mirzaei
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Traxl
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - K Komposch
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Glitzner
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - T Wanek
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Mairinger
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - M Russello
- Liver Unit ARNAS Garibaldi, Catania, Italy
| | - G Russo
- H.Pharmacy Department ARNAS Garibaldi, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - S Sorko
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - H J Gallowitsch
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Kohlfuerst
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Matschnig
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Rieser
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Sorschag
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - P Lind
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - L Ležaič
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Rep
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - J Žibert
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - N Frelih
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Šuštar
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - T Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - A Singh
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M Shahinfar
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - C Schuchardt
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - G F Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H R Kulkarni
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M C Fornito
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | | | - R Balzano
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | - G V Di Martino
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - G Russo
- Pharmacy H. Department Arnas Garibaldi, Catania, Italy
| | - W H Thomson
- Physics and Nuclear Medicine, City Hospital, Birmingham, UK
| | - M Kudlacek
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - M Karik
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - C Farhan
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - H Rieger
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - W Pokieser
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - S Mirzaei
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - V Petz
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - C Tugendsam
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - W Buchinger
- Schilddrueseninstitut Gleisdorf, Gleisdorf, Austria
| | - B Schmoll-Hauer
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - I P Schenk
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Sozialmedizinisches Zentrum Hietzing, Vienna, Austria
| | - K Rudolph
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - M Krebs
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Clinical Division of Endocrinology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - G Zettinig
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - V Zoufal
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Wanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Krohn
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - S Mairinger
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M Sauberer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Filip
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - O Langer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - F Weitzer
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - B Pernthaler
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - S Salamon
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - R Aigner
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - P Koranda
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - L Henzlová
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - M Kamínek
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - Mo Váchalová
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - P Bachleda
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - J Garousi
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - M Oroujeni
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - B Mitran
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - K G Andersson
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Vorobyeva
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - J N Löfblom
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Orlova
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - V Tolmachev
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - P Kaeopookum
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
- Research and Development Division, Thailand Institute of Nuclear Technology, Nakhonnayok, Thailand
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - T Orasch
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - B Lechner
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - M Petrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - Z Novy
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - C Rangger
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - H Haas
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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Aigner R, Buecking B, Hack J, Eschbach D, Oberkircher L, Ruchholtz S, Bliemel C. Pre-fracture hospitalization is associated with worse functional outcome and higher mortality in geriatric hip fracture patients. Arch Osteoporos 2017; 12:32. [PMID: 28349470 DOI: 10.1007/s11657-017-0327-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/16/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Hip fractures are common in elderly people. Despite great progress in surgical care, the outcomes of these patients remain disappointing. This study determined pre-fracture hospital admission as a prognostic variable for inferior functional outcomes and increased mortality rates in the perioperative phase and in the first postoperative year. PURPOSE The influence of a pre-fracture hospitalization on outcomes in hip fracture patients has not yet been investigated. METHODS Four hundred two patients who were surgically treated for hip fracture were prospectively enrolled. Patients with a hospital stay within the last 3 months prior to a hip fracture were compared to patients without a pre-fracture hospitalization. Postoperative functional outcomes and mortality rates were compared between groups at the time of hospital discharge and additionally at the six- and twelve-month follow-up appointments. A multivariate regression analysis was performed. RESULTS A pre-fracture hospitalization was reported by 67 patients (17%). In 63% of cases, patients were admitted due to non-surgical, general medical conditions. In 37% of cases, patients were treated due to a condition related to a surgical subject. In the multivariate analysis, pre-fracture hospitalization was an independent risk factor for reduced values on the Barthel Index at 6 months after surgery (B, -9.918; 95%CI of B, -19.001--0.835; p = 0.032) and on the Tinetti Test at 6 months (B, -2.914; 95%CI of B, -1.992--0.047; p = 0.047) and 12 months after surgery (B, -4.680; 95%CI of B, -8.042--1.319; p = 0.007). Pre-fracture hospitalization was additionally associated with increased mortality rates at 6 months (OR 1.971; 95%CI 1.052-3.693; p = 0.034) and 12 months after surgery (OR 1.888; 95%CI 1.010-9.529; p = 0.046). CONCLUSIONS Hip fracture patients with a recent pre-fracture hospital admission are at a substantial risk for inferior functional outcomes and increased mortality rates not only in the perioperative phase but also in the first postoperative year. As a simple dichotomous variable, pre-fracture hospitalization might be a suitable tool for future geriatric hip fracture screening instruments.
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Affiliation(s)
- Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Juliana Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Daphne Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Ludwig Oberkircher
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Christopher Bliemel
- Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
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Bliemel C, Buecking B, Hack J, Aigner R, Eschbach DA, Ruchholtz S, Oberkircher L. Urinary tract infection in patients with hip fracture: An underestimated event? Geriatr Gerontol Int 2017. [PMID: 28621029 DOI: 10.1111/ggi.13077] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Urinary tract infections (UTI) represent a common perioperative complication among elderly patients with hip fracture. To determine the impact of UTI on the perioperative course of elderly patients with hip fractures, a prospective study was carried out. METHODS A total of 402 surgically-treated geriatric hip fracture patients were consecutively enrolled at a level 1 trauma center. On admission, all patients received an indwelling urinary catheter. Clinically symptomatic patients were screened more closely for UTI. Patients diagnosed with UTI were compared with asymptomatic patients. Outcomes in both patient groups were measured using in-hospital mortality, overall length of hospital stay, wound infection, functional results and mobility at discharge. Multivariate regression analysis was carried out to control for influencing factors. RESULTS A total of 97 patients (24%) sustained a UTI during in-hospital treatment. UTI were independently associated with inferior functional outcomes as assessed by the Barthel Index (β = -0.091; P = 0.031), Timed Up and Go test (β = 0.364; P = 0.001) and Tinetti test (β = -0.169; P = 0.001) at discharge. Additionally, length of hospital stay was significantly longer for patients with a UTI diagnosis (β = 0.123; P = 0.029) after controlling for all other variables. No differences were observed in the rate of wound infection (odds ratio 1.185; P = 0.898) or in-hospital mortality (P < 0.997). CONCLUSIONS Patients with UTI seem to be at risk of inferior functional outcomes. In addition to an early detection of symptomatic UTI and a targeted antibiotic therapy, perioperative care should focus on preserving functional ability to protect these patients from further loss of independence and prolonged clinical courses. Geriatr Gerontol Int 2017; 17: 2369-2376.
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Affiliation(s)
- Christopher Bliemel
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
| | - Juliana Hack
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
| | | | - Steffen Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
| | - Ludwig Oberkircher
- Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Marburg, Germany
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Aigner R, Hellige R, Knippel S, Oberkircher L, Ruchholtz S, Buecking B. Internal fixation of acetabular fractures in an older population using the TIMI approach - Midterm results of a prospective study. Injury 2017; 48:890-896. [PMID: 28216064 DOI: 10.1016/j.injury.2017.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/03/2016] [Accepted: 02/02/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The incidence of geriatric acetabular fractures continues to increase due to demographic changes. In the elderly, anterior column fractures are common, and standard approaches are associated with a considerable risk for surgery-associated complications. Therefore, a minimally invasive approach was developed in our department. The aim of this study was to examine early and mid-term results regarding the use of this novel two-incision minimally invasive (TIMI) approach in patients aged over 55 years with acetabular fractures. METHODS From July 2007 to April 2014, 47 patients aged over 55 years were treated via the TIMI approach; these patients were included in the present prospective study. The patients' characteristics, data, and early phase of care were assessed during acute care. A radiological evaluation comprised pre- and postoperative CT scans and x-rays, including Judet views at follow-up. Follow-up examinations were performed after 6 and 24 months and comprised a clinical and radiological examination and an evaluation of hip function (Harris Hip Score) and health-related quality of life (EQ-5D). RESULTS The mean age of the patients was 74±11years, with a gender ratio of 35/12 (m/f). The average operation time was 93±30min, and perioperative blood loss amounted to 858±463ml. In total, five (11%) complications associated with the operative procedure occurred, and revision surgery was necessary in three patients. We observed no wound infections, abdominal wall hernias or cases of heterotopic ossification in our sample. The Harris Hip Score at six months after surgery was 81, and it slightly improved to 84 after 24 months. The mean EQ5D index was 0.91 at six months after surgery and 0.92 at 24 months after surgery. CONCLUSION The TIMI approach represents a valuable alternative to the ilioinguinal and modified Stoppa approach for the treatment of acetabular fractures located in the anterior column, which are often observed in geriatric patients. LEVEL OF EVIDENCE Therapeutic Level II (Prospective cohort study).
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Affiliation(s)
- Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany.
| | - Ralf Hellige
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany
| | - Sabine Knippel
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany
| | - Ludwig Oberkircher
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany
| | - Benjamin Buecking
- Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Germany
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Taumberger N, Pernthaler B, Schwarz T, Bjelic-Radisic V, Pristauz G, Aigner R, Tamussino K. Lymphoscintigraphy for sentinel lymph node biopsy in breast cancer: do we need a delayed image? Breast 2017. [DOI: 10.1016/s0960-9776(17)30389-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND Geriatric traumatology is increasing in importance due to the demographic transition. In cases of fractures close to large joints it is questionable whether primary joint replacement is advantageous compared to joint-preserving internal fixation. OBJECTIVE The aim of this study was to describe the importance of prosthetic joint replacement in the treatment of geriatric patients suffering from frequent periarticular fractures in comparison to osteosynthetic joint reconstruction and conservative methods. MATERIAL AND METHODS A selective search of the literature was carried out to identify studies and recommendations concerned with primary arthroplasty of fractures in the region of the various joints (hip, shoulder, elbow and knee). RESULTS The importance of primary arthroplasty in geriatric traumatology differs greatly between the various joints. Implantation of a prosthesis has now become the gold standard for displaced fractures of the femoral neck. In addition, reverse shoulder arthroplasty has become an established alternative option to osteosynthesis in the treatment of complex proximal humeral fractures. Due to a lack of large studies definitive recommendations cannot yet be given for fractures around the elbow and the knee. Nowadays, joint replacement for these fractures is recommended only if reconstruction of the joint surface is not possible. CONCLUSION The importance of primary joint replacement for geriatric fractures will probably increase in the future. Further studies with larger patient numbers must be conducted to achieve more confidence in decision making between joint replacement and internal fixation especially for shoulder, elbow and knee joints.
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Affiliation(s)
- B Buecking
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland.
| | - D Eschbach
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland
| | - C Bliemel
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland
| | - M Knobe
- Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
| | - R Aigner
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland
| | - S Ruchholtz
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland
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Ertl M, Aigner R, Krost M, Karnasová Z, Müller K, Naumann M, Schlachetzki F. Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal-pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests. Eur J Neurol 2016; 24:461-467. [DOI: 10.1111/ene.13225] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ertl
- Clinic for Neurology and Neurophysiology; Klinikum Augsburg; Augsburg Germany
| | - R. Aigner
- Clinic for Neurology and Neurophysiology; Klinikum Augsburg; Augsburg Germany
| | - M. Krost
- Clinic for Neurology and Neurophysiology; Klinikum Augsburg; Augsburg Germany
| | - Z. Karnasová
- Clinic for Neurology and Neurophysiology; Klinikum Augsburg; Augsburg Germany
| | - K. Müller
- Center for Clinical Studies; University Medical Center Regensburg; Regensburg Germany
| | - M. Naumann
- Clinic for Neurology and Neurophysiology; Klinikum Augsburg; Augsburg Germany
| | - F. Schlachetzki
- Department of Neurology; Clinic for Neurological Rehabiliation II; University of Regensburg; Regensburg Germany
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Bliemel C, Oberkircher L, Bockmann B, Petzold E, Aigner R, Heyse TJ, Ruchholtz S, Buecking B. Impact of cement-augmented condylar screws in locking plate osteosynthesis for distal femoral fractures - A biomechanical analysis. Injury 2016; 47:2688-2693. [PMID: 27773369 DOI: 10.1016/j.injury.2016.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/16/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Compromised bone quality and the need for early mobilization continue to lead to implant failure in elderly patients with distal femoral fractures. The cement augmentation of screws might facilitate improving implant anchorage. The aim of this study was to analyse the impact of cement augmentation of the condylar screws on implant fixation in a human cadaveric bone model. MATERIAL AND METHODS Ten pairs of osteoporotic femora (mean age: 90 years, range: 84-99 years) were used. A 2-cm gap osteotomy was created in the metaphyseal region to simulate an unstable AO/OTA 33-A3 fracture. All specimens were treated with a polyaxial locking plate. Specimens randomly assigned to the augmented group received an additional cement augmentation of the condylar screws using bone cement. A servohydraulic testing machine was used to perform incremental cyclic axial loading using a load-to-failure mode. RESULTS All specimens survived at least 800N of axial compressive force. The mean compressive forces leading to failure were 1620N (95% CI: 1382-1858N) in the non-augmented group and 2420N (95% CI: 2054-2786N) in the group with cement-augmented condylar screws (p=0.005). Deformation with cutting out of the condylar screws and condylar fracture were the most common reasons for failure in both groups. Whereas axial stiffness was comparable between both osteosyntheses (p=0.508), significant differences were observed for the plastic deformation of the constructs (p=0.014). CONCLUSION The results of the present study showed that the cement augmentation of the condylar screws might be a promising technique for the fixation of distal femoral fractures in elderly patients with osteoporotic bones.
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Affiliation(s)
- Christopher Bliemel
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Ludwig Oberkircher
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Benjamin Bockmann
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Eric Petzold
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Rene Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Thomas Jan Heyse
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Steffen Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
| | - Benjamin Buecking
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany.
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Aigner R, Meier Fedeler T, Eschbach D, Hack J, Bliemel C, Ruchholtz S, Bücking B. Patient factors associated with increased acute care costs of hip fractures: a detailed analysis of 402 patients. Arch Osteoporos 2016; 11:38. [PMID: 27815914 DOI: 10.1007/s11657-016-0291-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/25/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of the present study was to identify patient factors associated with higher costs in hip fracture patients. The mean costs of a prospectively observed sample of 402 patients were 8853 €. The ASA score, Charlson comorbidity index, and fracture location were associated with increased costs. PURPOSE Fractures of the proximal end of the femur (hip fractures) are of increasing incidence due to demographic changes. Relevant co-morbidities often present in these patients cause high complication rates and prolonged hospital stays, thus leading to high costs of acute care. The aim of this study was to perform a precise cost analysis of the actual hospital costs of hip fractures and to identify patient factors associated with increased costs. METHODS The basis of this analysis was a prospectively observed single-center trial, which included 402 patients with fractures of the proximal end of the femur. All potential cost factors were recorded as accurately as possible for each of the 402 patients individually, and statistical analysis was performed to identify associations between pre-existing patient factors and acute care costs. RESULTS The mean total acute care costs per patient were 8853 ± 5676 € with ward costs (5828 ± 4294 €) and costs for surgical treatment (1972 ± 956 €) representing the major cost factors. The ASA score, Charlson comorbidity index, and fracture location were identified as influencing the costs of acute care for hip fracture treatment. CONCLUSION Hip fractures are associated with high acute care costs. This study underlines the necessity of sophisticated risk-adjusted payment models based on specific patient factors. Economic aspects should be an integral part of future hip fracture research due to limited health care resources.
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Affiliation(s)
- R Aigner
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany.
| | - T Meier Fedeler
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - D Eschbach
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - J Hack
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - C Bliemel
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - S Ruchholtz
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - B Bücking
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany
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Taumberger N, Pernthaler B, Schwarz T, Bjelic-Radisic V, Pristauz-Telsnigg G, Aigner R, Tamussino K. Sentinel Node Biopsie bei Mammakarzinom: Was bringt das Spätbild? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Affiliation(s)
- M Brodmann
- Division of Angiology, Department of Internal Medicine, University Hospital Graz, Austria.
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Taumberger N, Pernthaler B, Schwarz T, Bjelic-Radisic V, Pristauz G, Aigner R, Tamussino K. Sentinel Node Markierung bei Mammakarzinom: Was bringt das Spätbild? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Langsteger W, Rezaee A, Loidl W, Geinitz HS, Fitz F, Steinmair M, Broinger G, Pallwien-Prettner L, Beheshti M, Imamovic L, Beheshti M, Rendl G, Hackl D, Tsybrovsky O, Steinmair M, Emmanuel K, Moinfar F, Pirich C, Langsteger W, Bytyqi A, Karanikas G, Mayerhöfer M, Koperek O, Niederle B, Hartenbach M, Beyer T, Herrmann K, Czernin J, Rausch I, Rust P, DiFranco MD, Lassen M, Stadlbauer A, Mayerhöfer ME, Hartenbach M, Hacker M, Beyer T, Binzel K, Magnussen R, Wei W, Knopp MU, Flanigan DC, Kaeding C, Knopp MV, Leisser A, Nejabat M, Hartenbach M, Kramer G, Krainer M, Hacker M, Haug A, Lehnert W, Schmidt K, Kimiaei S, Bronzel M, Kluge A, Wright CL, Binzel K, Zhang J, Wuthrick E, Maniawski P, Knopp MV, Blaickner M, Rados E, Huber A, Dulovits M, Kulkarni H, Wiessalla S, Schuchardt C, Baum RP, Knäusl B, Georg D, Bauer M, Wulkersdorfer B, Wadsak W, Philippe C, Haslacher H, Zeitlinger M, Langer O, Bauer M, Feldmann M, Karch R, Wadsak W, Zeitlinger M, Koepp MJ, Asselin MC, Pataraia E, Langer O, Zeilinger M, Philippe C, Dumanic M, Pichler F, Pilz J, Hacker M, Wadsak W, Mitterhauser M, Nics L, Steiner B, Hacker M, Mitterhauser M, Wadsak W, Traxl A, Wanek T, Kryeziu K, Mairinger S, Stanek J, Berger W, Kuntner C, Langer O, Mairinger S, Wanek T, Traxl A, Krohn M, Stanek J, Filip T, Sauberer M, Kuntner C, Pahnke J, Langer O, Svatunek D, Denk C, Wilkovitsch M, Wanek T, Filip T, Kuntner-Hannes C, Fröhlich J, Mikula H, Denk C, Svatunek D, Wanek T, Mairinger S, Stanek J, Filip T, Fröhlich J, Mikula H, Kuntner-Hannes C, Balber T, Singer J, Fazekas J, Rami-Mark C, Berroterán-Infante N, Jensen-Jarolim E, Wadsak W, Hacker M, Viernstein H, Mitterhauser M, Denk C, Svatunek D, Sohr B, Mikula H, Fröhlich J, Wanek T, Kuntner-Hannes C, Filip T, Pfaff S, Philippe C, Mitterhauser M, Hartenbach M, Hacker M, Wadsak W, Wanek T, Halilbasic E, Visentin M, Mairinger S, Stieger B, Kuntner C, Trauner M, Langer O, Lam P, Aistleitner M, Eichinger R, Artner C, Eidherr H, Vraka C, Haug A, Mitterhauser M, Nics L, Hartenbach M, Hacker M, Wadsak W, Kvaternik H, Müller R, Hausberger D, Zink C, Aigner RM, Cossío U, Asensio M, Montes A, Akhtar S, Te Welscher Y, van Nostrum R, Gómez-Vallejo V, Llop J, VandeVyver F, Barclay T, Lippens N, Troch M, Hehenwarter L, Egger B, Holzmannhofer J, Rodrigues-Radischat M, Pirich C, Pötsch N, Rausch I, Wilhelm D, Weber M, Furtner J, Karanikas G, Wöhrer A, Mitterhauser M, Hacker M, Traub-Weidinger T, Cassou-Mounat T, Balogova S, Nataf V, Calzada M, Huchet V, Kerrou K, Devaux JY, Mohty M, Garderet L, Talbot JN, Stanzel S, Pregartner G, Schwarz T, Bjelic-Radisic V, Liegl-Atzwanger B, Aigner R, Stanzel S, Quehenberger F, Aigner RM, Marković AK, Janković M, Jerković VM, Paskaš M, Pupić G, Džodić R, Popović D, Fornito MC, Familiari D, Koranda P, Polzerová H, Metelková I, Henzlová L, Formánek R, Buriánková E, Kamínek M, Thomson WH, Lewis C, Thomson WH, O'Brien J, James G, Notghi A, Huber H, Stelzmüller I, Wunn R, Mandl M, Fellner F, Lamprecht B, Gabriel M, Fornito MC, Leonardi G, Thomson WH, O'Brien J, James G, Hudzietzová J, Sabol J, Fülöp M. 32nd International Austrian Winter Symposium : Zell am See, the Netherlands. 20-23 January 2016. EJNMMI Res 2016; 6:32. [PMID: 27090254 PMCID: PMC4835428 DOI: 10.1186/s13550-016-0168-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 11/22/2022] Open
Abstract
A1 68Ga-PSMA PET/CT in staging and restaging of Prostate Cancer Patients: comparative study with 18F-Choline PET/CT W Langsteger, A Rezaee, W Loidl, HS Geinitz, F Fitz, M Steinmair, G Broinger, L Pallwien-Prettner, M Beheshti A2 F18 Choline PET – CT: an accurate diagnostic tool for the detection of parathyroid adenoma? L Imamovic, M Beheshti, G Rendl, D Hackl, O Tsybrovsky, M Steinmair, K Emmanuel, F Moinfar, C Pirich, W Langsteger A3 [18F]Fluoro-DOPA-PET/CT in the primary diagnosis of medullary thyroid carcinoma A Bytyqi, G Karanikas, M Mayerhöfer, O Koperek, B Niederle, M Hartenbach A4 Variations of clinical PET/MR operations: An international survey on the clinical utilization of PET/MRI T Beyer, K Herrmann, J Czernin A5 Standard Dixon-based attenuation correction in combined PET/MRI: Reproducibility and the possibility of Lean body mass estimation I Rausch, P Rust, MD DiFranco, M Lassen, A Stadlbauer, ME Mayerhöfer, M Hartenbach, M Hacker, T Beyer A6 High resolution digital FDG PET/MRI imaging for assessment of ACL graft viability K Binzel, R Magnussen, W Wei, MU Knopp, DC Flanigan, C Kaeding, MV Knopp A7 Using pre-existing hematotoxicity as predictor for severe side effects and number of treatment cycles of Xofigo therapy A Leisser, M Nejabat, M Hartenbach, G Kramer, M Krainer, M Hacker, A Haug A8 QDOSE – comprehensive software solution for internal dose assessment Wencke Lehnert, Karl Schmidt, Sharok Kimiaei, Marcus Bronzel, Andreas Kluge A9 Clinical impact of Time-of-Flight on next-generation digital PET imaging of Yttrium-90 radioactivity following liver radioembolization CL Wright, K Binzel, J Zhang, Evan Wuthrick, Piotr Maniawski, MV Knopp A10 Snakes in patients! Lessons learned from programming active contours for automated organ segmentation M Blaickner, E Rados, A Huber, M Dulovits, H Kulkarni, S Wiessalla, C Schuchardt, RP Baum, B Knäusl, D Georg A11 Influence of a genetic polymorphism on brain uptake of the dual ABCB1/ABCG2 substrate [11C]tariquidar M Bauer, B Wulkersdorfer, W Wadsak, C Philippe, H Haslacher, M Zeitlinger, O Langer A12 Outcome prediction of temporal lobe epilepsy surgery from P-glycoprotein activity. Pooled analysis of (R)-[11C]-verapamil PET data from two European centres M Bauer, M Feldmann, R Karch, W Wadsak, M Zeitlinger, MJ Koepp, M-C Asselin, E Pataraia, O Langer A13 In-vitro and in-vivo characterization of [18F]FE@SNAP and derivatives for the visualization of the melanin concentrating hormone receptor 1 M Zeilinger, C Philippe, M Dumanic, F Pichler, J Pilz, M Hacker, W Wadsak, M Mitterhauser A14 Reducing time in quality control leads to higher specific radioactivity of short-lived radiotracers L Nics, B Steiner, M Hacker, M Mitterhauser, W Wadsak A15 In vitro 11C-erlotinib binding experiments in cancer cell lines with epidermal growth factor receptor mutations A Traxl, Thomas Wanek, Kushtrim Kryeziu, Severin Mairinger, Johann Stanek, Walter Berger, Claudia Kuntner, Oliver Langer A16 7-[11C]methyl-6-bromopurine, a PET tracer to measure brain Mrp1 function: radiosynthesis and first PET evaluation in mice S Mairinger, T Wanek, A Traxl, M Krohn, J Stanek, T Filip, M Sauberer, C Kuntner, J Pahnke, O Langer A17 18F labeled azidoglucose derivatives as “click” agents for pretargeted PET imaging D Svatunek, C Denk, M Wilkovitsch, T Wanek, T Filip, C Kuntner-Hannes, J Fröhlich, H Mikula A18 Bioorthogonal tools for PET imaging: development of radiolabeled 1,2,4,5-Tetrazines C Denk, D Svatunek, T Wanek, S Mairinger, J Stanek, T Filip, J Fröhlich, H Mikula, C Kuntner-Hannes A19 Preclinical evaluation of [18F]FE@SUPPY- a new PET-tracer for oncology T Balber, J Singer, J Fazekas, C Rami-Mark, N Berroterán-Infante, E Jensen-Jarolim, W Wadsak, M Hacker, H Viernstein, M Mitterhauser A20 Investigation of Small [18F]-Fluoroalkylazides for Rapid Radiolabeling and In Vivo Click Chemistry C Denk, D Svatunek, B Sohr, H Mikula, J Fröhlich, T Wanek, C Kuntner-Hannes, T Filip A21 Microfluidic 68Ga-radiolabeling of PSMA-HBED-CC using a flow-through reactor S Pfaff, C Philippe, M Mitterhauser, M Hartenbach, M Hacker, W Wadsak A22 Influence of 24-nor-ursodeoxycholic acid on hepatic disposition of [18F]ciprofloxacin measured with positron emission tomography T Wanek, E Halilbasic, M Visentin, S Mairinger, B Stieger, C Kuntner, M Trauner, O Langer A23 Automated 18F-flumazenil production using chemically resistant disposable cassettes P Lam, M Aistleitner, R Eichinger, C Artner A24 Similarities and differences in the synthesis and quality control of 177Lu-DOTA-TATE, 177Lu -HA-DOTA-TATE and 177Lu-DOTA-PSMA (PSMA-617) H Eidherr, C Vraka, A Haug, M Mitterhauser, L Nics, M Hartenbach, M Hacker, W Wadsak A25 68Ga- and 177Lu-labelling of PSMA-617 H Kvaternik, R Müller, D Hausberger, C Zink, RM Aigner A26 Radiolabelling of liposomes with 67Ga and biodistribution studies after administration by an aerosol inhalation system U Cossío, M Asensio, A Montes, S Akhtar, Y te Welscher, R van Nostrum, V Gómez-Vallejo, J Llop A27 Fully automated quantification of DaTscan SPECT: Integration of age and gender differences F VandeVyver, T Barclay, N Lippens, M Troch A28 Lesion-to-background ratio in co-registered 18F-FET PET/MR imaging – is it a valuable tool to differentiate between low grade and high grade brain tumor? L Hehenwarter, B Egger, J Holzmannhofer, M Rodrigues-Radischat, C Pirich A29 [11C]-methionine PET in gliomas - a retrospective data analysis of 166 patients N Pötsch, I Rausch, D Wilhelm, M Weber, J Furtner, G Karanikas, A Wöhrer, M Mitterhauser, M Hacker, T Traub-Weidinger A30 18F-Fluorocholine versus 18F-Fluorodeoxyglucose for PET/CT imaging in patients with relapsed or progressive multiple myeloma: a pilot study T Cassou-Mounat, S Balogova, V Nataf, M Calzada, V Huchet, K Kerrou, J-Y Devaux, M Mohty, L Garderet, J-N Talbot A31 Prognostic benefit of additional SPECT/CT in sentinel lymph node mapping of breast cancer patients S Stanzel, G Pregartner, T Schwarz, V Bjelic-Radisic, B Liegl-Atzwanger, R Aigner A32 Evaluation of diagnostic value of TOF-18F-FDG PET/CT in patients with suspected pancreatic cancer S Stanzel, F Quehenberger, RM Aigner A33 New quantification method for diagnosis of primary hyperpatahyroidism lesions and differential diagnosis vs thyropid nodular disease in dynamic scintigraphy A Koljević Marković, Milica Janković, V Miler Jerković, M Paskaš, G Pupić, R Džodić, D Popović A34 A rare case of diffuse pancreatic involvement in patient with merkel cell carcinoma detected by 18F-FDG MC Fornito, D Familiari A35 TSH-stimulated 18F-FDG PET/CT in the diagnosis of recurrent/metastatic radioiodine-negative differentiated thyroid carcinomas in patients with various thyroglobuline levels P Koranda, H Polzerová, I Metelková, L Henzlová, R Formánek, E Buriánková, M Kamínek A36 Breast Dose from lactation following I131 treatment WH Thomson, C Lewis A37 A new concept for performing SeHCAT studies with the gamma camera WH Thomson, J O’Brien, G James, A Notghi A38 Whole body F-18-FDG-PET and tuberculosis: sensitivity compared to x-ray-CT H Huber, I Stelzmüller, R Wunn, M Mandl, F Fellner, B Lamprecht, M Gabriel A39 Emerging role 18F-FDG PET-CT in the diagnosis and follow-up of the infection in heartware ventricular assist system (HVAD) MC Fornito, G Leonardi A40 Validation of Poisson resampling software WH Thomson, J O’Brien, G James A41 Protection of PET nuclear medicine personnel: problems in satisfying dose limit requirements J Hudzietzová, J Sabol, M Fülöp
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Affiliation(s)
- W Langsteger
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - A Rezaee
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - W Loidl
- Prostate Cancer Center Linz, Department of Urology, St Vincent's Hospital, Linz, Austria
| | - H S Geinitz
- Department of Radiation Oncology, St Vincent's Hospital, Linz, Austria
| | - F Fitz
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - M Steinmair
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - G Broinger
- Department of Radiology, St Vincent's Hospital, Linz, Austria
| | - L Pallwien-Prettner
- PET - CT Center Linz & Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - M Beheshti
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - L Imamovic
- PET - CT Center Linz & Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - M Beheshti
- PET - CT Center Linz & Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - G Rendl
- Department of Nuclear Medicine and Endocrinology, Paracelsus Private Medical University Salzburg, St Vincent's Hospital, Linz, Austria
| | - D Hackl
- Department of Surgery, St Vincent's Hospital, Linz, Austria
| | - O Tsybrovsky
- Department of Pathology, St Vincent's Hospital, Linz, Austria
| | - M Steinmair
- PET - CT Center Linz & Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - K Emmanuel
- Department of Surgery, St Vincent's Hospital, Linz, Austria
| | - F Moinfar
- Department of Pathology, St Vincent's Hospital, Linz, Austria
| | - C Pirich
- Department of Nuclear Medicine and Endocrinology, Paracelsus Private Medical University Salzburg, St Vincent's Hospital, Linz, Austria
| | - W Langsteger
- PET - CT Center Linz & Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - A Bytyqi
- PET-CT Center Linz, Department of Nuclear Medicine & Endocrinology, St Vincent's Hospital, Linz, Austria
| | - G Karanikas
- Medical University of Vienna, Division of Nuclear Medicine, Vienna, Austria
| | - M Mayerhöfer
- Medical University of Vienna, Division of General and Pediatric Radiology, Vienna, Austria
| | - O Koperek
- Medical University of Vienna, Institute of Pathology, Vienna, Austria
| | - B Niederle
- Medical University Vienna, Division of Surgical Endocrinology, Vienna, Austria
| | - M Hartenbach
- Medical University of Vienna, Division of Nuclear Medicine, Vienna, Austria
| | - T Beyer
- QIMP, CMPBME, Medical University of Vienna, ᅟ, Austria
| | - K Herrmann
- Department of Nuclear Medicine, University of Würzburg, ᅟ, Germany.,Department of Molecular and Medical Pharmacology, UCLA, ᅟ, USA
| | - J Czernin
- Department of Molecular and Medical Pharmacology, UCLA, ᅟ, USA
| | - I Rausch
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, ᅟ, Austria
| | - P Rust
- Department of Nutritional Sciences, University of Vienna, ᅟ, Austria
| | - M D DiFranco
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, ᅟ, Austria
| | - M Lassen
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, ᅟ, Austria
| | - A Stadlbauer
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, ᅟ, Austria
| | - M E Mayerhöfer
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, ᅟ, Austria
| | - M Hartenbach
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, ᅟ, Austria
| | - T Beyer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, ᅟ, Austria
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - R Magnussen
- Sports Medicine, The Ohio State University, Columbus, OH, USA
| | - W Wei
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - M U Knopp
- Sports Medicine, Pepperdine University, Malibu, CA, USA
| | - D C Flanigan
- Sports Medicine, The Ohio State University, Columbus, OH, USA
| | - C Kaeding
- Sports Medicine, The Ohio State University, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - A Leisser
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Nejabat
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hartenbach
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - G Kramer
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Krainer
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - A Haug
- Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - Wencke Lehnert
- ABX-CRO advanced pharmaceutical services (Forschungsgesellschaft mbH), Dresden, Germany
| | - Karl Schmidt
- ABX-CRO advanced pharmaceutical services (Forschungsgesellschaft mbH), Dresden, Germany
| | - Sharok Kimiaei
- ABX-CRO advanced pharmaceutical services (Forschungsgesellschaft mbH), Dresden, Germany
| | - Marcus Bronzel
- ABX-CRO advanced pharmaceutical services (Forschungsgesellschaft mbH), Dresden, Germany
| | - Andreas Kluge
- ABX-CRO advanced pharmaceutical services (Forschungsgesellschaft mbH), Dresden, Germany
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - Evan Wuthrick
- Radiation Oncology, Wexner Medical Center at The Ohio State University, Columbus, OH, USA
| | - Piotr Maniawski
- Clinical Science - Nuclear Medicine, Philips Healthcare, Cleveland, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - M Blaickner
- AIT Austrian Institute of Technology, Health & Environment Department -Biomedical Systems, Vienna, Austria
| | - E Rados
- AIT Austrian Institute of Technology, Health & Environment Department -Biomedical Systems, Vienna, Austria
| | - A Huber
- AIT Austrian Institute of Technology, Health & Environment Department -Biomedical Systems, Vienna, Austria
| | - M Dulovits
- Woogieworks Animation Studio, Perchtoldsdorf, Austria
| | - H Kulkarni
- THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka, ᅟ, Germany
| | - S Wiessalla
- THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka, ᅟ, Germany
| | - C Schuchardt
- THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka, ᅟ, Germany
| | - R P Baum
- THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka, ᅟ, Germany
| | - B Knäusl
- Department of Radiation Oncology, Division of Medical Radiation Physics, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, ᅟ, Austria
| | - D Georg
- Department of Radiation Oncology, Division of Medical Radiation Physics, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, ᅟ, Austria
| | - M Bauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B Wulkersdorfer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - C Philippe
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - H Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - M Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Bauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
| | - M Feldmann
- Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,University College London, London, UK
| | - R Karch
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - M Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M J Koepp
- University College London, London, UK
| | - M-C Asselin
- Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
| | - E Pataraia
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M Zeilinger
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - C Philippe
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Dumanic
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - F Pichler
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - J Pilz
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Radiopharmacy and Experimental Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Ludwig Boltzmann Institute for Applied Diagnostics, Vienna, Austria
| | - L Nics
- Department of Biomedical Imaging and Image guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - B Steiner
- Department of Biomedical Imaging and Image guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Mitterhauser
- Ludwig Boltzmann Institute for Applied Diagnostics, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - A Traxl
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Thomas Wanek
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Kushtrim Kryeziu
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Severin Mairinger
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Johann Stanek
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Walter Berger
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Claudia Kuntner
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Oliver Langer
- Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - S Mairinger
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Wanek
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - A Traxl
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Krohn
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - J Stanek
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Filip
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sauberer
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - C Kuntner
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - O Langer
- Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - D Svatunek
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - C Denk
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - M Wilkovitsch
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - T Wanek
- Austrian Institute of Technology, Vienna, Austria
| | - T Filip
- Austrian Institute of Technology, Vienna, Austria
| | | | - J Fröhlich
- Austrian Institute of Technology, Vienna, Austria
| | - H Mikula
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - C Denk
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - D Svatunek
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - T Wanek
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - S Mairinger
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - J Stanek
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - T Filip
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - J Fröhlich
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - H Mikula
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - C Kuntner-Hannes
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - T Balber
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - J Singer
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Department of Immunology and Oncology, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, ᅟ, Austria.,Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, ᅟ, Austria
| | - J Fazekas
- Department of Immunology and Oncology, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, ᅟ, Austria.,Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, ᅟ, Austria
| | - C Rami-Mark
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - N Berroterán-Infante
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - E Jensen-Jarolim
- Department of Immunology and Oncology, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, ᅟ, Austria.,Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, ᅟ, Austria
| | - W Wadsak
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - H Viernstein
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Sciences, University of Vienna, ᅟ, Austria
| | - M Mitterhauser
- Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - C Denk
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - D Svatunek
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - B Sohr
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - H Mikula
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - J Fröhlich
- Institute of Applied Synthetic Chemistry, TU Wien, Vienna, Austria
| | - T Wanek
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - C Kuntner-Hannes
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - T Filip
- Austrian Institute of Technology, Biomedical Systems, Vienna, Austria
| | - S Pfaff
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Department of Inorganic Chemistry, University of Vienna, ᅟ, Austria
| | - C Philippe
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,LBI for Applied Diagnostics, Vienna, Austria
| | - M Hartenbach
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Department of Inorganic Chemistry, University of Vienna, ᅟ, Austria
| | - T Wanek
- Health and Environment Department, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - E Halilbasic
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - M Visentin
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland
| | - S Mairinger
- Health and Environment Department, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - B Stieger
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland
| | - C Kuntner
- Health and Environment Department, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Health and Environment Department, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna, ᅟ, Austria
| | - P Lam
- IASON GmbH, Feldkirchnerstraße 4, A-8054, Graz-Seiersberg, Austria
| | - M Aistleitner
- IASON GmbH, Feldkirchnerstraße 4, A-8054, Graz-Seiersberg, Austria
| | - R Eichinger
- IASON GmbH, Feldkirchnerstraße 4, A-8054, Graz-Seiersberg, Austria
| | - C Artner
- IASON GmbH, Feldkirchnerstraße 4, A-8054, Graz-Seiersberg, Austria
| | - H Eidherr
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - C Vraka
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, ᅟ, Austria
| | - A Haug
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,LBI for Applied Diagnostics, Vienna, Austria
| | - L Nics
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria.,Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, ᅟ, Austria
| | - M Hartenbach
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ᅟ, Austria
| | - H Kvaternik
- Department of Radiology, Division of Nuclear Medicine, Medical University of Graz, ᅟ, Austria
| | - R Müller
- Seibersdorf Labor GmbH, ᅟ, Austria
| | - D Hausberger
- Department of Radiology, Division of Nuclear Medicine, Medical University of Graz, ᅟ, Austria
| | - C Zink
- Department of Radiology, Division of Nuclear Medicine, Medical University of Graz, ᅟ, Austria
| | - R M Aigner
- Department of Radiology, Division of Nuclear Medicine, Medical University of Graz, ᅟ, Austria
| | - U Cossío
- CIC biomaGUNE, Edificio Empresarial "C", Paseo de Miramón 182, 20009, Donostia, Spain
| | - M Asensio
- Engineering Department, Ingeniatrics Tecnologies, P.I. Parque Plata, Camino Mozárabe 41, 41900, Camas-Sevilla, Spain
| | - A Montes
- Engineering Department, Ingeniatrics Tecnologies, P.I. Parque Plata, Camino Mozárabe 41, 41900, Camas-Sevilla, Spain
| | - S Akhtar
- Department of Pharmaceutics, University of Utrecht, Utrecht, The Netherlands
| | - Y Te Welscher
- Department of Pharmaceutics, University of Utrecht, Utrecht, The Netherlands
| | - R van Nostrum
- Department of Pharmaceutics, University of Utrecht, Utrecht, The Netherlands
| | - V Gómez-Vallejo
- CIC biomaGUNE, Edificio Empresarial "C", Paseo de Miramón 182, 20009, Donostia, Spain
| | - J Llop
- CIC biomaGUNE, Edificio Empresarial "C", Paseo de Miramón 182, 20009, Donostia, Spain
| | | | | | | | - M Troch
- AZ St-Lucas Gent, ᅟ, Belgium
| | - L Hehenwarter
- Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Private Medical University Salzburg, ᅟ, Germany
| | - B Egger
- Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Private Medical University Salzburg, ᅟ, Germany
| | - J Holzmannhofer
- Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Private Medical University Salzburg, ᅟ, Germany
| | - M Rodrigues-Radischat
- Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Private Medical University Salzburg, ᅟ, Germany
| | - C Pirich
- Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Private Medical University Salzburg, ᅟ, Germany
| | - N Pötsch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - I Rausch
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - D Wilhelm
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - M Weber
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - J Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - G Karanikas
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - A Wöhrer
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - T Traub-Weidinger
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - T Cassou-Mounat
- Department of Nuclear Medicine, Hôpital Saint Antoine, AP-HP et Université Pierre et Marie Curie (UPMC), Paris, France.,Department of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie (UPMC), Paris, France
| | - S Balogova
- Department of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie (UPMC), Paris, France.,Department of Nuclear Medicine, Comenius university & St. Elisabeth Oncology Institute, Bratislava, Slovakia
| | - V Nataf
- Radiopharmacy, Hôpital Tenon, AP-HP, Paris, France
| | - M Calzada
- Department of Nuclear Medicine, Hôpital Saint Antoine, AP-HP et Université Pierre et Marie Curie (UPMC), Paris, France
| | - V Huchet
- Department of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie (UPMC), Paris, France
| | - K Kerrou
- Department of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie (UPMC), Paris, France
| | - J-Y Devaux
- Department of Nuclear Medicine, Hôpital Saint Antoine, AP-HP et Université Pierre et Marie Curie (UPMC), Paris, France
| | - M Mohty
- Hematology, Université Pierre et Marie Curie, Paris, France.,Hôpital Saint-Antoine, AP-HP, Paris, France.,INSERM UMRs U938, Paris, France
| | - L Garderet
- Hematology, Université Pierre et Marie Curie, Paris, France
| | - J-N Talbot
- Department of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie (UPMC), Paris, France
| | - S Stanzel
- Medical University of Graz, Department of Radiology, Division of Nuclear Medicine, ᅟ, Austria
| | - G Pregartner
- Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, ᅟ, Austria
| | - T Schwarz
- Medical University of Graz, Department of Radiology, Division of Nuclear Medicine, ᅟ, Austria
| | - V Bjelic-Radisic
- Medical University of Graz, Department of Gynecology and Obstetrics, ᅟ, Austria
| | | | - R Aigner
- Medical University of Graz, Department of Radiology, Division of Nuclear Medicine, ᅟ, Austria
| | - S Stanzel
- Medical University of Graz, Department of Radiology, Division of Nuclear Medicine, ᅟ, Austria
| | - F Quehenberger
- Institute for Medical Informatics, Statistics, and Documentation, ᅟ, Austria
| | - R M Aigner
- Medical University of Graz, Department of Radiology, Division of Nuclear Medicine, ᅟ, Austria
| | - A Koljević Marković
- Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000, Belgrade, Serbia
| | - Milica Janković
- National Cancer Research Center Serbia, University of Belgrade- School of Electrical Engineering, ᅟ, Serbia
| | - V Miler Jerković
- National Cancer Research Center Serbia, University of Belgrade- School of Electrical Engineering, ᅟ, Serbia
| | - M Paskaš
- National Cancer Research Center Serbia, Innovation Center, University of Belgrade - Faculty of Electrical Engineering, ᅟ, Serbia
| | - G Pupić
- National Cancer Research Center Serbia, University of Belgrade- School of Electrical Engineering, ᅟ, Serbia
| | - R Džodić
- National Cancer Research Center Serbia, University of Belgrade- School of Electrical Engineering, ᅟ, Serbia
| | - D Popović
- National Cancer Research Center Serbia, University of Belgrade- School of Electrical Engineering, ᅟ, Serbia
| | - M C Fornito
- Nuclear Medicine Department and PET/CT center - A.R.N.A.S " Garibaldi - Nesima", Via Palermo 636, 95122, Catania, Italy
| | - D Familiari
- Nuclear Medicine Department and PET/CT center - A.R.N.A.S " Garibaldi - Nesima", Via Palermo 636, 95122, Catania, Italy
| | - P Koranda
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - H Polzerová
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - I Metelková
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - L Henzlová
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - R Formánek
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - E Buriánková
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - M Kamínek
- Department of Nuclear Medicine, Palacky University and University Hospital, Olomouc, Czech Republic
| | - W H Thomson
- Physics and Nuclear Medicine Department City Hospital, Birmingham, UK
| | - C Lewis
- Maternity Department City Hospital, Birmingham, UK
| | - W H Thomson
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - J O'Brien
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - G James
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - A Notghi
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - H Huber
- Institut für Nuklearmedizin und Endokrinologie, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - I Stelzmüller
- Abteilung für Lungenkrankheiten, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - R Wunn
- Zentrales Radiologie-Institut, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - M Mandl
- Abteilung für Lungenkrankheiten, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - F Fellner
- Zentrales Radiologie-Institut, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - B Lamprecht
- Abteilung für Lungenkrankheiten, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - M Gabriel
- Institut für Nuklearmedizin und Endokrinologie, AKH Linz/Kepler Universitätsklinikum, ᅟ, Austria
| | - M C Fornito
- Nuclear Medicine Department and PET/CT center - A.R.N.A.S " Garibaldi - Nesima", Via Palermo 636, 95122, Catania, Italy
| | - G Leonardi
- Heart-Failure Department - Azienda Ospedaliera Universitaria "Policlinico- Vittorio Emanuele", Catania, Italy
| | - W H Thomson
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - J O'Brien
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - G James
- Physics and Nuclear Medicine Department, City Hospital, Birmingham, UK
| | - J Hudzietzová
- Faculty of Biomedical Engineering, CTU, Prague, Czech Republic
| | - J Sabol
- Faculty of Safety Management, PACR, Prague, Czech Republic
| | - M Fülöp
- Faculty of Public Health, SMU, Bratislava, Slovak Republic
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Ruchholtz S, Bücking B, Zettl R, Aigner R, Mand C, Kühne C. Two-Incision Minimally Invasive Approach for the Treatment of Anterior Column Acetabular Fractures. JBJS Essent Surg Tech 2015; 5:e13. [PMID: 30473921 PMCID: PMC6221420 DOI: 10.2106/jbjs.st.n.00101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction We describe an alternative to the Letournel ilioinguinal approach for anterior column acetabular fractures that is performed with a unique retraction device that decreases the rate of soft-tissue complications. Step 1 Position the Patient and Identify the Sites for the Incisions Identify the sites for both incisions with the help of an image intensifier. Step 2 Make the First Incision to Expose the Anterior Column and the Linea Terminalis Pelvic Brim Make the first incision to expose the central area of the fracture. Step 3 Make the Second Incision to Expose the Symphysis and the Ipsilateral Pubic Bone Make the second incision to expose the area for the distal plate fixation. Step 4 Maintain Exposure of the Linea Terminalis Using a Soft-Tissue Retraction System For better visualization, use a soft-tissue retraction system. Step 5 Reduce the Fracture Clean and reduce the fracture through the first incision. Step 6 Fix the Fracture Perform temporary and definitive fixation according to the standards for anterior acetabular fracture fixation. Step 7 Close the Wound After radiographic documentation in three views, close the wound. Results We reported the results of a case-control study of the first twenty-six patients operated on with the two-incision minimally invasive technique.IndicationsContraindicationsPitfalls & Challenges.
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Affiliation(s)
- Steffen Ruchholtz
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany. E-mail address for S. Ruchholtz: . E-mail address for B. Bücking: . E-mail address for R. Aigner: . E-mail address for C. Mand: . E-mail address for C. Kühne:
| | - Benjamin Bücking
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany. E-mail address for S. Ruchholtz: . E-mail address for B. Bücking: . E-mail address for R. Aigner: . E-mail address for C. Mand: . E-mail address for C. Kühne:
| | - Ralph Zettl
- Unfallchirurgie Kantonsspital Frauenfeld, Pfaffenholzstrasse 4, 8501 Frauenfeld, Switzerland. E-mail address:
| | - Rene Aigner
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany. E-mail address for S. Ruchholtz: . E-mail address for B. Bücking: . E-mail address for R. Aigner: . E-mail address for C. Mand: . E-mail address for C. Kühne:
| | - Carsten Mand
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany. E-mail address for S. Ruchholtz: . E-mail address for B. Bücking: . E-mail address for R. Aigner: . E-mail address for C. Mand: . E-mail address for C. Kühne:
| | - Christian Kühne
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany. E-mail address for S. Ruchholtz: . E-mail address for B. Bücking: . E-mail address for R. Aigner: . E-mail address for C. Mand: . E-mail address for C. Kühne:
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López CL, Wurmb T, Mand C, Aigner R, Kühne CA. [In-hospital trauma management - damage control]. Anasthesiol Intensivmed Notfallmed Schmerzther 2014; 49:526-33; quiz 534. [PMID: 25238012 DOI: 10.1055/s-0034-1390058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Damage Control is a strategy for the initial treatment phase in severely injured patients. The aim is to avoid time consuming surgical procedures thereby reducing secondary damage and to improve patients' outcome. Once the patient is haemodynamically stabilized on the intensive care unit, definitive therapy - i. e. osteosynthesis, bowel/urinary tract reconstruction etc. - can be performed after a time interval of 5-10 days. Thus Damage Control is a quick and focused but preliminary treatment strategy in the initial emergency phase in critically injured patients.
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Aigner R, Debus F, Karaman Y, López-López C, Ruchholtz S, Kühne CA. [Outcomes after operative treatment of distal radius fractures - an analysis of 721 patients]. Z Orthop Unfall 2014; 152:375-80. [PMID: 25144848 DOI: 10.1055/s-0034-1368633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM OF THE STUDY Treatment strategies in distal radius fractures differ nationally and internationally. Conservative and operative treatment options compete as well as implants, postoperative therapy regimens and the necessity of implant removal. In our institution operative treatment is favoured. In the following the results of 721 surgically treated patients are presented. PATIENTS PATIENTS who underwent operative treatment of their distal radius fractures in our institution between 2008 and 2011 were retrospectively analysed. Following patient characteristics have been surveyed regarding age, sex, location of plate osteosynthesis, operation time, time of cast immobilisation and complications like infections, tendon ruptures, need of revision surgery. RESULTS 721 patients (mean age: 59.03 years) were retrospectively analysed. 514 of them (71.29 %) were female. Time of operation was after a mean duration of 5.48 days. In 558 (77.39 %) patients we performed palmar plate osteosynthesis. 89 (12.34 %) had dorsal plate osteosynthesis and 74 (10.3 %) cases were treated with either K-wires or screws. 18 (2.5 %) patients had concomitant traumatic carpal tunnel syndrome and a concomitant SL rupture was seen in 38 (5.27 %) patients. 40 (5.55 %) patients underwent operative revision because of posttraumatic carpal tunnel syndrome (n = 15), tendon ruptures (n = 7), malposition of screws (n = 6), loss of reduction (n = 6) and infection (n = 3). Mean duration of in-hospital stay after operation was 6.6 days. Implant removal was performed in 77 (10.7) patients; 59 (8.2 %) patients had palmar plate osteosynthesis and 18 (2.5 %) patients had dorsal plating. CONCLUSION Because of the low complication rate after operative treatment of distal radius fractures, osteosynthesis of this fracture seems to be warranted. Regarding the patients' higher age we have seen an unexpectedly long in-hospital stay with a mean time of 6.6 days. Herein attempts should be made to reduce time of in-hospital stay. In our opinion implant removal should not be recommended routinely.
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Affiliation(s)
- R Aigner
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - F Debus
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - Y Karaman
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C López-López
- Klinik für Viszeral-, Thorax und Gefäßchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - S Ruchholtz
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C A Kühne
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
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Debus F, Karaman Y, Ruchholtz S, Aigner R, Wirries A, Kühne CA. The distal radius fracture: concomitant fractures and their relevancy. Technol Health Care 2014; 22:877-84. [PMID: 25059252 DOI: 10.3233/thc-140840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The distal radius keeps heading the list of commonly fractured bones. Although little is known about the frequency and localization of accompanying fractures as well as their influence on the total course of in-patient treatment. OBJECTIVE This study is supposed to show the influence of concomitant fractures. These fractures should be identified as risk factors for a prolonged stay to improve the in hospital treatment. METHODS We retrospectively reviewed 721 patients with distal radius fracture. Frequency and localization of concomitant fractures, AO-type, patient age as well as duration of in-hospital treatment were analyzed. RESULTS Out of 721 patients 124 (17.2%) had one or more concomitant fractures (CF). The most common CF were proximal femur fractures, pelvic ring fractures and humerus fractures. Compared to patients without CF, these patients showed a significant increase in duration of post operative hospital stay (5.2 vs. 12.5 days, p=0.0001). CONCLUSIONS Patients presenting a concomitant fracture should be thoroughly cared for by their physicians and therapists. Especially an early and focused mobilization and a well-timed relocation for further medical treatment are important to reduce avoidable treatment days in the acute care hospital.
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Affiliation(s)
- Florian Debus
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Yeliz Karaman
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Steffen Ruchholtz
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Rene Aigner
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Andre Wirries
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Christian Alexander Kühne
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg, Marburg, Germany
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Schröttner B, Gstettner C, Aigner R. Osteolytische Knochenprozesse im SPECT-CT bei einer Patientin mit jahrzehntelang bestehender Anorexia nervosa. ROFO-FORTSCHR RONTG 2013; 185:569-71. [DOI: 10.1055/s-0032-1330681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stanzel S, Beham-Schmid C, Aigner R. [A rare case of undifferentiated thymus carcinoma with multiple metastasis]. ROFO-FORTSCHR RONTG 2012. [PMID: 23196832 DOI: 10.1055/s-0032-1330319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kulnik R, Köfer K, Aigner R. F18-FDG-PET-CT zur Darstellung extramedullärer Manifestationen bei Patienten mit Multiplem Myelom. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1324425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Endres S, Aigner R, Wilke A. Instrumented intervertebral or posterolateral fusion in elderly patients: clinical results of a single center. BMC Musculoskelet Disord 2011; 12:189. [PMID: 21851614 PMCID: PMC3170647 DOI: 10.1186/1471-2474-12-189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 08/18/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Data on the clinical outcome after spinal fusion in the elderly patient are rare. To our knowledge there has been no clinical outcome assessment for instrumented spinal fusion in elderly patients comparing posterolateral fusion with intervertebral fusion. Aim of the current study was to evaluate the clinical outcome of elderly patients who underwent a spinal fusion procedure for degenerative spinal stenosis with instability. Main hypothesis was to test whether it is necessary to force an intervertebral fusion for a better clinical outcome in spinal fusion surgery of the elderly or not. METHODS Two subgroups - posterolateral fusion versus intervertebral fusion (cage vs. non-cage) were compared with regard to functional outcome, fusion rates and complications after a mean follow up of 3.8 years. Questionnaires were completed by the patients before surgery and at final follow-up. Changes in mean VAS and ODI scores (decrease from the baseline VAS and ODI scores) were compared. RESULTS The mean final follow up for all subjects was 3.8 years. Of the 114 patients, 2 patients were deceased at the time of the follow-up, 5 patients didn't want to participate and 107 patients completed the questionnaires. This resulted in an overall follow-up rate of 93%. At final follow-up, the patients demonstrated significant improvement in the VAS and ODI- compared with the preoperative scores in both groups. But overall there were no significant differences between both groups regarding the outcome assessment using the ODI and VAS. CONCLUSIONS The results of this study shows that elderly patients aged over 75 benefit from instrumented lumbar fusion. The study suggests that there is no need to force an intervertebral fusion because elderly patients do not seem to benefit from this procedure.
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Affiliation(s)
- Stefan Endres
- Department of orthopaedic surgery, Elisabeth-Klinik Bigge/Olsberg, Heinrich Sommer Strasse 4, 59939 Olsberg, Germany.
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Winner B, Melrose HL, Zhao C, Hinkle KM, Yue M, Kent C, Braithwaite AT, Ogholikhan S, Aigner R, Winkler J, Farrer MJ, Gage FH. Adult neurogenesis and neurite outgrowth are impaired in LRRK2 G2019S mice. Neurobiol Dis 2010; 41:706-16. [PMID: 21168496 DOI: 10.1016/j.nbd.2010.12.008] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/01/2010] [Accepted: 12/10/2010] [Indexed: 01/19/2023] Open
Abstract
The generation and maturation of adult neural stem/progenitor cells are impaired in many neurodegenerative diseases, among them is Parkinson's disease (PD). In mammals, including humans, adult neurogenesis is a lifelong feature of cellular brain plasticity in the hippocampal dentate gyrus (DG) and in the subventricular zone (SVZ)/olfactory bulb system. Hyposmia, depression, and anxiety are early non-motor symptoms in PD. There are parallels between brain regions associated with non-motor symptoms in PD and neurogenic regions. In autosomal dominant PD, mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are frequent. LRRK2 homologs in non-vertebrate systems play an important role in chemotaxis, cell polarity, and neurite arborization. We investigated adult neurogenesis and the neurite development of new neurons in the DG and SVZ/olfactory bulb system in bacterial artificial chromosome (BAC) human Lrrk2 G2019S transgenic mice. We report that mutant human Lrrk2 is highly expressed in the hippocampus in the DG and the SVZ of adult Lrrk2 G2019S mice. Proliferation of newly generated cells is significantly decreased and survival of newly generated neurons in the DG and olfactory bulb is also severely impaired. In addition, after stereotactic injection of a GFP retrovirus, newly generated neurons in the DG of Lrrk2 G2019S mice exhibited reduced dendritic arborization and fewer spines. This loss in mature, developed spines might point towards a decrease in synaptic connectivity. Interestingly, physical activity partially reverses the decrease in neuroblasts observed in Lrrk2 G2010S mice. These data further support a role for Lrrk2 in neuronal morphogenesis and provide new insights into the role of Lrrk2 in adult neurogenesis.
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Affiliation(s)
- B Winner
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA 92186, USA.
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Stiegler P, Schaffellner S, Hackl F, Iberer F, Aigner R, Christine B, Tscheliessnigg K, Stadlbauer V. Isoprostanes as markers of oxidative stress-induced cell damage in porcine islet cell isolation. Transplant Proc 2010; 42:1618-20. [PMID: 20620486 DOI: 10.1016/j.transproceed.2009.11.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 11/24/2009] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Mechanical stress and reagents used during the isolation and purification process as well as digestion time and temperature can alter the success of porcine islet cell (PIC) isolation. This study aimed to characterize the occurrence of isoprostanes during PIC isolation using a modified automated Ricordi method and to evaluate their influence on PIC isolation outcome. METHODS Porcine pancreatic tissue was harvested at the local slaughter house, and 10 PIC isolations were performed using a modified automated Ricordi method. As positive controls for tissue damage-associated oxidative stress, six consecutive PIC isolations were performed in the presence of 1 mug lipopolysaccharide (LPS). PIC were purified by density gradient centrifugation using the Lymphoprep density gradient. Isoprostane measurement was performed using enzyme-linked immunosorbent assay. RESULTS The final yield of viable and pure PICs in the experimental group was 3479 +/- 542 IEQ/g pancreas, and the LPS group yielded lower cell numbers compared to the experimental group. Isoprostane levels were significantly elevated in the LPS group as compared to the experimental group at all time points during the isolation from the beginning of the digestion process. DISCUSSION PIC isolation and purification results significantly differed in the two experimental groups, underlining the negative effects of oxidative stress on PIC viability and purity, which impact negatively on PIC transplantation success.
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Affiliation(s)
- P Stiegler
- Department of Surgery, Division for Transplantation Surgery, Medical University Graz, Graz, Austria.
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Sauseng W, Nagel B, Gamillscheg A, Aigner R, Borkenstein M, Zotter H. Acylated ghrelin increases after controlled short-time exercise in school-aged children. Scand J Med Sci Sports 2010; 21:e100-5. [DOI: 10.1111/j.1600-0838.2010.01165.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Aigner R. Hybridgeräte – Status quo und zukünftige Entwicklung – PET-CT. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rottensteiner M, Tamussino K, Bader A, Aigner R, Schwarz T, Regauer S, Richtig E, Lahousen M, Winter R. Das Sentinel Lymphknoten Konzept beim Vulvakarzinom. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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