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Can a combination of different risk factors be correlated with leg fracture healing time?

Massari L, Falez F, Lorusso V, Zanon G, Ciolli L, La Cava F, Cadossi M, Chiarello E, De Terlizzi F, Setti S, Benazzo FM - J Orthop Traumatol (2012)

Bottom Line: Continuous variables were compared between groups using Student's heteroschedastic two-tail t test.However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07).The ARRCO score is significantly associated with fracture healing time and could be used to identify "fractures at risk," allowing early intervention to stimulate osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic and Traumatology Department, Sant'Anna Hospital, University of Ferrara, Via Savonarola 9, 44121, Ferrara, Italy.

ABSTRACT

Background: A multicenter retrospective analysis of patients treated for leg fractures was conducted to develop a score that correlates with fracture healing time and to identify the risk gradient for delayed healing.

Methods: Fifty-three patients were analyzed and considered healed when full weight bearing was possible. Patients were divided into those who healed within 180 days and those who took longer to heal. Risk factors associated with delayed healing, fracture morphology, and orthopedic treatments were recorded. The available literature was used to weight the relative risk associated with each factor; values were combined into a score evaluating the risk of delayed healing: L-ARRCO (a literature-based score where the risk of delayed bone healing is calculated using a specific algorithm). Other risk factors associated with delayed healing were then considered in order to calculate a new score, ARRCO. Continuous variables were compared between groups using Student's heteroschedastic two-tail t test. Receiver operating characteristic (ROC) curves and the areas under the curves were calculated to determine the ability of this score to discriminate subjects with delayed healing.

Results: The mean L-ARRCO scores of the patients who healed within and after 180 days were significantly different (5.78 ± 1.59 and 7.05 ± 2.46, respectively). The mean ARRCO scores of the patients who healed within and after 180 days were also significantly different (5.92 ± 1.78 and 9.03 ± 2.79, respectively). However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07).

Conclusions: The ARRCO score is significantly associated with fracture healing time and could be used to identify "fractures at risk," allowing early intervention to stimulate osteogenesis.

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Related in: MedlinePlus

ROC curve for discriminating subjects with healing times of <180 days from subjects who suffered delayed healing
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Fig5: ROC curve for discriminating subjects with healing times of <180 days from subjects who suffered delayed healing

Mentions: In the discrimination analysis between subjects who healed within 180 days and those who took longer than 180 days, the ROC curve with the ARRCO score gave an AUC that was significantly greater (0.82 ± 0.07, CI 0.69–0.96) than that obtained with the L-ARRCO score (0.62 ± 0.09, CI 0.46–0.79), p < 0.0001 (Fig. 5). Importantly, for 70 % specificity values, a sensitivity of 82 % was achieved with the ARRCO score, whereas only 41 % sensitivity was achieved with the L-ARRCO score.Fig. 5


Can a combination of different risk factors be correlated with leg fracture healing time?

Massari L, Falez F, Lorusso V, Zanon G, Ciolli L, La Cava F, Cadossi M, Chiarello E, De Terlizzi F, Setti S, Benazzo FM - J Orthop Traumatol (2012)

ROC curve for discriminating subjects with healing times of <180 days from subjects who suffered delayed healing
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585952&req=5

Fig5: ROC curve for discriminating subjects with healing times of <180 days from subjects who suffered delayed healing
Mentions: In the discrimination analysis between subjects who healed within 180 days and those who took longer than 180 days, the ROC curve with the ARRCO score gave an AUC that was significantly greater (0.82 ± 0.07, CI 0.69–0.96) than that obtained with the L-ARRCO score (0.62 ± 0.09, CI 0.46–0.79), p < 0.0001 (Fig. 5). Importantly, for 70 % specificity values, a sensitivity of 82 % was achieved with the ARRCO score, whereas only 41 % sensitivity was achieved with the L-ARRCO score.Fig. 5

Bottom Line: Continuous variables were compared between groups using Student's heteroschedastic two-tail t test.However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07).The ARRCO score is significantly associated with fracture healing time and could be used to identify "fractures at risk," allowing early intervention to stimulate osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic and Traumatology Department, Sant'Anna Hospital, University of Ferrara, Via Savonarola 9, 44121, Ferrara, Italy.

ABSTRACT

Background: A multicenter retrospective analysis of patients treated for leg fractures was conducted to develop a score that correlates with fracture healing time and to identify the risk gradient for delayed healing.

Methods: Fifty-three patients were analyzed and considered healed when full weight bearing was possible. Patients were divided into those who healed within 180 days and those who took longer to heal. Risk factors associated with delayed healing, fracture morphology, and orthopedic treatments were recorded. The available literature was used to weight the relative risk associated with each factor; values were combined into a score evaluating the risk of delayed healing: L-ARRCO (a literature-based score where the risk of delayed bone healing is calculated using a specific algorithm). Other risk factors associated with delayed healing were then considered in order to calculate a new score, ARRCO. Continuous variables were compared between groups using Student's heteroschedastic two-tail t test. Receiver operating characteristic (ROC) curves and the areas under the curves were calculated to determine the ability of this score to discriminate subjects with delayed healing.

Results: The mean L-ARRCO scores of the patients who healed within and after 180 days were significantly different (5.78 ± 1.59 and 7.05 ± 2.46, respectively). The mean ARRCO scores of the patients who healed within and after 180 days were also significantly different (5.92 ± 1.78 and 9.03 ± 2.79, respectively). However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07).

Conclusions: The ARRCO score is significantly associated with fracture healing time and could be used to identify "fractures at risk," allowing early intervention to stimulate osteogenesis.

Show MeSH
Related in: MedlinePlus