Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation
Background: Anemia and abnormal platelet count are common among patients with cancer and are associated with complications after orthopaedic procedures. We studied associations between these conditions and morbidity within 30 days after surgery for pathologic femur or humerus fracture. Methods: We r...
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| Language: | English |
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Elsevier
2025-06-01
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| Series: | Journal of Bone Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S221213742500020X |
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| author | Mohyeddine El Sayed Ryley Zastrow Sassine Youssef Adam S. Levin |
| author_facet | Mohyeddine El Sayed Ryley Zastrow Sassine Youssef Adam S. Levin |
| author_sort | Mohyeddine El Sayed |
| collection | DOAJ |
| description | Background: Anemia and abnormal platelet count are common among patients with cancer and are associated with complications after orthopaedic procedures. We studied associations between these conditions and morbidity within 30 days after surgery for pathologic femur or humerus fracture. Methods: We retrospectively reviewed data from the National Surgery Quality Improvement Project database for 145,030 adults following surgical fixation of a pathologic femur or humerus fracture from 2010 to 2020. Multivariable logistic regressions compared 30-day complications between patients with mild or severe anemia versus those with normal hematocrit and between patients with thrombocytopenia or thrombocytosis versus those with normal platelet count. Results: Likelihood of extended hospitalization (≥6 days) was higher in patients with mild anemia (odds ratio [OR]: 1.47; 95 % confidence interval [CI]: 1.44, 1.51) and severe anemia (OR: 2.14; 95 % CI: 2.06, 2.23). Likelihood of all-cause morbidity was also higher among those with mild anemia (OR: 1.17; 95 % CI: 1.13, 1.21) and severe anemia (OR: 1.35; 95 % CI: 1.28, 1.42). Similarly, likelihood of extended hospitalization was higher in patients with thrombocytopenia (OR: 1.25; 95 % CI: 1.22, 1.29) and thrombocytosis (OR: 1.24; 95 % CI: 1.13, 1.36). Likelihood of all-cause morbidity was also higher for those with thrombocytopenia (OR: 1.12; 95 % CI: 1.07, 1.16) and thrombocytosis (OR: 1.21; 95 % CI: 1.07, 1.37). Conclusion: Preoperative anemia and platelet abnormalities were potentially modifiable risk factors associated with postoperative complications following surgery for pathologic fracture. |
| format | Article |
| id | doaj-art-bc2b9bf7795e47228fb4ba775b3b96b0 |
| institution | Kabale University |
| issn | 2212-1374 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj-art-bc2b9bf7795e47228fb4ba775b3b96b02025-08-20T03:47:01ZengElsevierJournal of Bone Oncology2212-13742025-06-015210067910.1016/j.jbo.2025.100679Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixationMohyeddine El Sayed0Ryley Zastrow1Sassine Youssef2Adam S. Levin3Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USAThe Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USAMedical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USAThe Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA; Corresponding author at: Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287, USA.Background: Anemia and abnormal platelet count are common among patients with cancer and are associated with complications after orthopaedic procedures. We studied associations between these conditions and morbidity within 30 days after surgery for pathologic femur or humerus fracture. Methods: We retrospectively reviewed data from the National Surgery Quality Improvement Project database for 145,030 adults following surgical fixation of a pathologic femur or humerus fracture from 2010 to 2020. Multivariable logistic regressions compared 30-day complications between patients with mild or severe anemia versus those with normal hematocrit and between patients with thrombocytopenia or thrombocytosis versus those with normal platelet count. Results: Likelihood of extended hospitalization (≥6 days) was higher in patients with mild anemia (odds ratio [OR]: 1.47; 95 % confidence interval [CI]: 1.44, 1.51) and severe anemia (OR: 2.14; 95 % CI: 2.06, 2.23). Likelihood of all-cause morbidity was also higher among those with mild anemia (OR: 1.17; 95 % CI: 1.13, 1.21) and severe anemia (OR: 1.35; 95 % CI: 1.28, 1.42). Similarly, likelihood of extended hospitalization was higher in patients with thrombocytopenia (OR: 1.25; 95 % CI: 1.22, 1.29) and thrombocytosis (OR: 1.24; 95 % CI: 1.13, 1.36). Likelihood of all-cause morbidity was also higher for those with thrombocytopenia (OR: 1.12; 95 % CI: 1.07, 1.16) and thrombocytosis (OR: 1.21; 95 % CI: 1.07, 1.37). Conclusion: Preoperative anemia and platelet abnormalities were potentially modifiable risk factors associated with postoperative complications following surgery for pathologic fracture.http://www.sciencedirect.com/science/article/pii/S221213742500020XAnemiaCancerOutcomesPathologic fractureThrombocytopeniaThrombocytosis |
| spellingShingle | Mohyeddine El Sayed Ryley Zastrow Sassine Youssef Adam S. Levin Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation Journal of Bone Oncology Anemia Cancer Outcomes Pathologic fracture Thrombocytopenia Thrombocytosis |
| title | Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| title_full | Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| title_fullStr | Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| title_full_unstemmed | Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| title_short | Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| title_sort | associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation |
| topic | Anemia Cancer Outcomes Pathologic fracture Thrombocytopenia Thrombocytosis |
| url | http://www.sciencedirect.com/science/article/pii/S221213742500020X |
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