J Korean Soc Traumatol.  2019 Dec;32(4):220-225. 10.20408/jti.2019.028.

The Timing of Femur Fracture Fixation is an Important Factor for Prolonged Mechanical Ventilation

• Choi HC
• Jung KH
• Kyoung KH
• Choi SH

• KMID: 2470090
• DOI: http://doi.org/10.20408/jti.2019.028

Abstract

PURPOSE
Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures.
METHODS
We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV.
RESULTS
In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572-0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546-0.889; p=0.031).
CONCLUSIONS
This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

Keyword

Mechanical ventilation; Fracture of long bone; Fixation of femoral fracture

MeSH Terms

Area Under Curve
Emergency Service, Hospital
Erythrocytes
Femur*
Fracture Fixation*
Fractures, Bone
Humans
Mortality
Respiration, Artificial*
Retrospective Studies
Risk Factors