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Cancer status seen as predictor of systemic complications after surgery for metastatic humeral lesions
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Recently published results showed poor cancer status was an independent predictor of postoperative systemic complications among patients who underwent surgery for metastatic humeral lesions, according to results.
Among 295 patients with a metastatic humeral lesion, 45% of lesions were proximal; 44% were diaphyseal; and 10% were distal impending or pathologic fractures. Researchers noted treatment included intramedullary nailing, prosthesis, plate-screw fixation, and a combination in proximal lesions; intramedullary nailing, plate-screw fixation, and a combination in diaphyseal lesions; and plate-screw fixation and intramedullary nailing in distal lesions. The primary outcome was reoperation, while the secondary outcome was a non-pre-existing systemic complication 30 days after the index surgery.
Stein J. Janssen
Results showed 8.5% of patients had reoperations, with the reoperation rate increasing from 2.6% at 1 month to 19% at 2 years. However, patients who underwent reoperation experienced a longer rate of survival, according to results. In a bivariate analysis, researchers noted patients with a higher white blood cell count, higher BMI and longer anesthesia time had a higher risk of reoperation.
According to results, 5.8% of patients experienced postoperative systemic complications, including pneumonia, sepsis, pulmonary embolism and fat embolism. An increased systemic complication rate was associated with poor cancer status and longer duration of hospital admission, researchers noted.
Compared with patients who underwent intramedullary nailing, results showed patients who underwent plate-screw fixation experienced a lower complication rate. Researchers found the modified Bauer score was independently associated with the outcome of systemic complications when they controlled for possible confounding variables in the multivariable logistic regression analysis. – by Casey Tingle
Disclosures: Janssen received research funding from Anna Foundation, Michael van Vloten Foundation, De Drie Lichten Foundation and KWF Kankerbestrijding. Please see the full study for a list of all other authors’ relevant financial disclosures.
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