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. 2020 Apr 3;15(1):128.
doi: 10.1186/s13018-020-01632-7.

Serum albumin level predicts survival after surgical treatment of metastatic femur fractures: a retrospective study

David Shaoen Sim  1   2 , Suraya Zainul-Abidin  3 , Eileen Yilin Sim  3 , Chu Sheng Seng  3 , Shern-En Evan Tan  3 , Mann Hong Tan  3 , Tet Sen Howe  3 , Joyce Suang Bee Koh  3
Affiliations

Serum albumin level predicts survival after surgical treatment of metastatic femur fractures: a retrospective study

David Shaoen Sim et al. J Orthop Surg Res. .

Abstract

Background: Surgical treatment for metastatic pathological femur fractures is associated with high mortality. Correct estimation of prognosis helps in determining the palliative value of surgical treatment and informs surgical decision. This study evaluates the risk factors for mortality in these patients who were surgically treated.

Methods: This is a retrospective study of 112 patients with surgical treatment of metastatic pathological femur fractures. Risk factors evaluated included age, ASA status, Charlson comorbidity index, preoperative serum albumin and haemoglobin, primary tumour site, presence of visceral metastases, presence of spinal metastases, time from diagnosis of cancer to occurrence of pathological fracture, type of surgical procedure performed, lesion and whether treatment was received for an actual or impending fracture. A Cox regression model was used to determine if these factors were independent significant factors for survival.

Results: Mortality at 2 years after surgical treatment of metastatic femoral fractures was 86%. Cox regression analysis of risk factors revealed that preoperative serum albumin and type primary tumour were independent risk factors for mortality. Presence of visceral metastases was strongly correlated to serum albumin levels.

Conclusion: Preoperative serum albumin level and primary tumour site are independent risk factors of survival in patients treated for pathological femur fractures. Serum albumin level may be used as a prognostic tool to guide treatment in this cohort of patients with high mortality rates.

Keywords: Albumin; Metastatic femur fracture; Risk factor; Survival.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival estimate according to the degree of hypoalbuminemia
Fig. 2
Fig. 2
Kaplan-Meier survival estimate according to the primary cancer site
See this image and copyright information in PMC

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