PubMed Health⌕ Search

Biomedical subjects

R Wenn

Publications and source records attributed to R Wenn.

8 recordsLinked to original sources
PubMed2005

POSSUM scoring for patients with fractured neck of femur.

BACKGROUND: POSSUM scoring is validated as an audit tool in general and orthopaedic surgery. It is also used for preoperative triage to assess perioperative risk. However its ability to predict mortality in specific surgical subgroups, such as patients with fractured neck of the femur, has not been studied. This study assessed the predictive capability of POSSUM for 30-day mortality after surgery for fractured neck of femur. METHODS: A cohort study was conducted in Queen's Medical Centre, Nottingham over a period of nearly 2 yr. Complete data from 1164 patients were analysed to compare the mortality predicted by POSSUM and the observed mortality. POSSUM risk of death was calculated using the original POSSUM equation, with modifications to the operative score appropriate for orthopaedic surgery. RESULTS: POSSUM predicted 181 (15.6%) deaths and the observed mortality was 119 (10.2%). The area under the receiver operating characteristic curve was 0.62, indicating poor performance by the POSSUM equation. CONCLUSION: POSSUM overpredicts mortality in hip fracture patients. It should be used with caution whether as an audit tool or for preoperative triage.

Adult↗
PubMed2004

Mortality following surgery for undisplaced intracapsular hip fractures.

PURPOSE: The aim of the study was to evaluate the mortality following the operative treatment of undisplaced subcapital fracture of the hip by internal fixation (with three lag screws) or hemiarthroplasty. METHODS: A prospective audit of all patients admitted with hip fracture was undertaken at the university hospital in Nottingham. An independent research assistant collected data on a standardised questionnaire. Mortality was calculated from data received from National office of Statistics allowing 100% 1-year follow up for mortality statistics. RESULTS: One hundred and sixty patients were admitted with undisplaced intracapsular fracture of the hip. Twenty-one patients had non-operative management and were excluded from the results. One hundred and thirty-nine patients had surgical treatment. Mean age of patients was 78 years. Twenty-nine patients had hemiarthroplasty and 110 patients underwent internal fixation of their fractures. There was no significant difference between the two groups for age, sex, mobility, residential status, co-morbidity and cognitive state. There was a significant difference in mortality between the two operated groups at 1 month and 1 year after the operation. Six patients (21%) died after hemiarthroplasty in the first month while there were only two (2%) deaths in the internal fixation group (P < 0.001). At 1 year from operation, 11 patients (38%) from the hemiarthroplasty group and 17 patients (16%) from the internal fixation group died (P = 0.0072). The re-operation rate within 1 year was higher for the internal fixation group (n = 8; 7.2%) than the hemiarthroplasty group (n = 1; 3%). CONCLUSIONS: There is significant increase in mortality when undisplaced intracapsular hip fractures are treated by hemiarthroplasty as compared to internal fixation and we would not recommend it for these fractures.

Aged↗