Intervention for impending pathological fractures at proximal femur is associated with lower mortality rates in patients with intermediate-to-high risk according to the Katagiri-New score

• Published in: BMC musculoskeletal disorders 2024-10, Vol.25 (1), p.836-7, Article 836
• Main Authors: Nishimoto, Toshiyuki, Shimizu, Hirokazu, Matsuoka, Masatake, Takahashi, Daisuke, Shimizu, Tomohiro, Iwasaki, Norimasa, Kuwahara, Ken, Soma, Tamotsu, Hiraga, Hiroaki, Iwata, Akira
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Body mass index; Bone surgery; Cancer; Care and treatment; Chemotherapy; Female; Femoral Fractures - mortality; Femoral Fractures - surgery; Femur; Fracture at proximal femur; Fractures; Fractures, Spontaneous - etiology; Fractures, Spontaneous - mortality; Fractures, Spontaneous - prevention & control; Fractures, Spontaneous - surgery; Health aspects; Humans; Impending fracture; Intervention; Katagiri score; Long bone; Male; Medical prognosis; Metastases; Metastasis; Middle Aged; Mortality; Mortality rate; Oncology; Patient outcomes; Quality of life; Radiation therapy; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Survival; Systemic diseases; Tomography
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07838-8

Prophylactic intervention for impending pathological fractures (IF) is associated with improved survival in patients with long-bone metastasis. However, information regarding whether the tumor burden and/or physical status are associated with survival benefits of intervention for IF is lacking. This multicenter retrospective study investigated 121 patients who underwent surgery for 63 impending and 58 complete metastatic fractures of the proximal femur between 2008 and 2023. After matching for age, sex, body mass index, and Katagiri-New score, 42 patients with IF were compared with 42 patients with complete pathological fractures. The 1-year mortality rate was considered the primary outcome, and was compared and stratified by risk based on the Katagiri-New score. The 1-year mortality rate was evaluated according to the surgical method in the subgroup analysis of patients with IF. The 1-year mortality rate was significantly lower in patients with IF with intermediate-to-high risk(p = 0.04), whereas no difference was observed in patients with low-to-high risk. IF was associated with a significantly higher rate of home discharge (p