Nonoperative management

1. Nonoperative management increases mortality in humans (16.4% vs 9.3%, HR 1.29, 95% CI 1.23 to 1.36).

   “The one-year mortality rate was higher after nonoperative treatment with 16.4% compared to surgical treatment with 9.3% (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.23 to 1.36; p < 0.001)”

   Humansnonoperative vs surgical treatment1 year

   Proximal humerus fractures - epidemiology, comparison of mortality rates after surgical versus non-surgical treatment, and analysis of risk factors based on Medicare registry data

   Bone & joint research·Feb 1, 2023

1. Nonoperative management impairs survival in humans.

   “Only poor prognosis and patients who refused OM (I, II, IV) had worse survival than OM patients.”

   Humanship fracture patients with poor prognosis or who refused operative managementup to 36 monthsn = 11,210

   Nonoperative hip fracture management practices and patient survival compared to surgical care: an analysis of Estonian population-wide data

   Archives of osteoporosis·Jun 25, 2021

1. Nonoperative management raises the risk of mortality in humans (OR 2.89, 95% CI 1.40-5.98).

   “In patients with frailty, multivariable analysis showed both nonoperative management (odds ratio [OR], 2.89; 95% CI, 1.40-5.98; P < .001)”

   Humansuncomplicated appendicitis in patients with frailty

   Outcomes Following Surgical and Nonsurgical Treatment for Uncomplicated Appendicitis in Older Adults

   JAMA network open·Aug 1, 2024

2. Nonoperative management is associated with mortality in humans (87% 30-day, 99% 1-year).

   “The 30-day and 1-year mortality in the frail NOM group was 87% and 99% respectively, whereas this was 7% and 28% in the surgery group.”

   Humanship fracture in very frail elderly patientsn = 91

   Nonoperative management of hip fractures in very frail elderly patients may lead to a predictable short survival as part of advance care planning

   Acta orthopaedica·Jul 28, 2021

3. Nonoperative management is associated with mortality in humans.

   “nonoperative management has been found to be associated with increased mortality.”

   Reviewankle fractures

   Ankle fractures in the elderly: risks and management challenges

   Orthopedic research and reviews·May 29, 2017

1. Nonoperative management is associated with functional status in humans (67.1%).

   “Approximately 67.1% of the entire cohort retained all three functional metrics.”

   Humanslow-energy ankle fractureaverage 41.6 weeksn = 158

   Functional Outcomes After Nonoperative Management in Older Adult Low-Energy Stable and Unstable Ankle Fractures: A Retrospective Review of 158 Patients

   Geriatric orthopaedic surgery & rehabilitation·Dec 8, 2024

1. Nonoperative management is associated with ambulatory status in humans (86% (n = 136)).

   “Eighty-six percent of patients (n = 136) retained their ambulatory status at long-term follow up.”

   Humanslow-energy ankle fractureaverage 41.6 weeksn = 158

   Functional Outcomes After Nonoperative Management in Older Adult Low-Energy Stable and Unstable Ankle Fractures: A Retrospective Review of 158 Patients

   Geriatric orthopaedic surgery & rehabilitation·Dec 8, 2024

1. Nonoperative management lowers the risk of hospital complications in humans (OR 0.77, 95% CI 0.64-0.94).

   “immediate appendectomy was associated with increased hospital complications compared with nonoperative management (OR, 0.77; 95% CI, 0.64-0.94; P = .009)”

   Humansuncomplicated appendicitis in patients without frailty

   Outcomes Following Surgical and Nonsurgical Treatment for Uncomplicated Appendicitis in Older Adults

   JAMA network open·Aug 1, 2024

1. Nonoperative management raises the risk of in-hospital mortality in humans (6.51% vs. 1.32%, p < .0001).

   “Compared to the group with operative treatment, the nonoperative group had a higher in-hospital mortality rate (6.51% vs. 1.32%, p < .0001).”

   Humanship fracture

   Characteristics and Factors Associated With Nonoperative Management and Hospital Outcomes After Hip Fractures Among Community-Dwelling Older Adults: Retrospective Analysis

   Journal of applied gerontology : the official journal of the Southern Gerontological Society·Jul 20, 2024

1. KATZ-6-ADL is associated with nonoperative management in humans (OR 1.17 (95% CI, 1.14-1.20) P < 0.001).

   “activities of daily living (ADL) measured as KATZ-6-ADL [OR 1.17 (95% CI, 1.14-1.20) P < 0.001] were independently associated with NOM”

   Humanship fracture

   Characteristics and Outcomes of Nonoperatively Managed Patients With Hip Fracture Using the Dutch Hip Fracture Audit

   Journal of orthopaedic trauma·Jan 23, 2024

More on KATZ-6-ADL

1. No functional mobility is associated with nonoperative management in humans (OR 4.39 (95% CI, 3.14-3.68) P < 0.001).

   “no functional mobility [OR 4.39 (95% CI, 3.14-3.68) P < 0.001]”

   Humanship fracture

   Characteristics and Outcomes of Nonoperatively Managed Patients With Hip Fracture Using the Dutch Hip Fracture Audit

   Journal of orthopaedic trauma·Jan 23, 2024

1. Dementia is associated with nonoperative management in humans (OR 1.31 (95% CI, 1.18-1.45) P < 0.001).

   “dementia [odds ratio (OR) 1.31 (95% confidence interval, CI, 1.18-1.45) P < 0.001]”

   Humanship fracture

   Characteristics and Outcomes of Nonoperatively Managed Patients With Hip Fracture Using the Dutch Hip Fracture Audit

   Journal of orthopaedic trauma·Jan 23, 2024

More on Dementia