1.Is Follow-up Co-Morbidity Assessment via Laboratory Investigations in Older High Energy Trauma Patients Justified? - A Prospective-Retrospective Study
Jain G ; Vadivelu G ; Krishna A ; Malhotra R ; Sharma V ; Farooque K
Malaysian Orthopaedic Journal 2023;17(No.1):1-9
Introduction: The objective of the current study was to test
our hypothesis that older patients sustaining high energy
trauma need to be evaluated for their comorbidities similar to
geriatric patients sustaining low energy trauma.
Materials and methods: This study was a retrospectiveprospective analysis of 173 patients of more than 50 years of
age enrolled between November 2017 and December 2018.
Herewith, we have compared retrospectively collected
laboratory investigations of 124 fragility fracture patients
with prospectively collected laboratory investigations of 49
patients with high energy trauma. The laboratory
investigations, including the liver function tests, renal
function tests, indices of calcium metabolism, serum
electrolytes, complete blood counts, and bone mineral
density (BMD) scores.
Results: Both groups were similar to each other as far as
baseline demographic characteristics were concerned. The
proportion of female patients and patients with nonosteoporotic range BMD (T-score >-2.5) was significantly
higher in the high-energy fracture group (P value <0.05).
Hypoalbuminemia (<3.4gm/dl) 17.3%, abnormalities
sodium (<135mmol/L or >148mmol/L) 23.2%, Anaemia
(<10g/dl) 12.7%, Hypercalcemia (>10.4mg/dl) 16.3%,
Vitamin D deficiency (<20ng/ml) 17.3% are the common
laboratory abnormality found in study population. No
statistically significant difference was found among the two
groups in terms of laboratory investigation abnormalities.
Conclusion: The laboratory investigation abnormality in an
older patient with a clinical fracture is independent of the
mechanism of injury. The results of the current study
emphasise the need for a comprehensive laboratory workup
in older patients with either high- energy fractures or
fragility fractures.