IMPACT OF OTHER MEDICAL CONDITIONS ON PAIN AND FUNCTIONALITY FOLLOWING TOTAL HIP ARTHROPLASTY: A PROSPECTIVE COHORT STUDY.

Background Total hip arthroplasty is the procedure carried out for patients suffering from arthritis. Arthritis is a painful bone inflammation that severely affects the functional ability of the hip bone. Total hip arthroplasty helps in reduction of the painful inflammation and it also helps in restoring the functional ability of the hip bone  Method This was a prospective study including individuals who underwent total hip arthroplasty at Rajendra Institute of Medical Sciences, Ranchi. The 30 patients participating in the study underwent the total hip arthroplasty. Patients were asked to follow up after 3 months, 6 months, 12 months, and 24 months of the surgery. Preoperatively, after the surgery and during the follow-up the hip bone was assessed using WOMAC score survey form 36.  Results Comorbidities increased with age, affecting postoperative outcomes. Higher CCI values led to poorer functional improvements and more complications, sometimes necessitating conservative measures. Older patients and those with higher CCIs had higher complication rates and readmissions. CCI rose with age, from 0.29 for patients <40 to 5.42 for those >70. Significant improvements in WOMAC and SF-36 scores were seen at the third-month follow-up, but higher CCI patients declined after six months. Patients with CCI >3 had three surgical complications, while CCI 2 patients had two complications related to infection. No complications occurred in patients with CCI 0 and 1, but one patient with a higher CCI died.  Conclusion From this study, it was found that the occurrence of comorbidity after the THA significantly decreased patient satisfaction. Also, the higher preoperative CCI resulted in the occurrence of comorbidity, delayed improvement, decreased recovery, increased rate of readmission, and decreased satisfaction of the patient.  Recommendation This association can guide clinicians in taking appropriate steps to intervene in the occurrence of comorbidities and treatment of the comorbidities to improve patient satisfaction

A RETROSPECTIVE COHORT STUDY ASSESSING MORTALITY RISKS IN PATIENTS WITH CRANIOMAXILLOFACIAL TRAUMA AND POLYTRAUMA USING THE INJURY SEVERITY SCORE (ISS) AND THE NEW INJURY SEVERITY SCORE (NISS).

BACKGROUND There is no consistent difference in postoperative complications between early and delayed therapy for craniomaxillofacial trauma and polytrauma patients. Prognosis and fatality risk drive treatment selection. Two assessment scores, Injury Severity Score (ISS) and New Injury Severity Score (NISS) gauge trauma severity objectively, but their accuracy details remain scarce. Data on concurrent craniomaxillofacial trauma patients are limited, with conflicting conclusions among researchers. OBJECTIVE To determine and contrast the threshold (critical) values of the ISS and NISS evaluation scales that indicate the likelihood of a fatal outcome in patients suffering from polytrauma and craniomaxillofacial trauma. MATERIALS AND METHODS A retrospective analysis was conducted. Patients with facial bone fractures, soft tissue traumas, and concurrent injuries were included. Data on demographics, injuries, treatments, and outcomes were collected. ISS and NISS were calculated, and statistical analyses were performed to determine threshold values for predicting fatal outcomes. RESULTS Thirty patients were included, with assaults (43.3%), falls (20%), and motor vehicle accidents (16.7%) being the leading causes of trauma. Craniocerebral traumas (30%) and extremity traumas (23.3%) were common. Fifteen fatal cases (3%) were identified, with cerebral edema (73.3%) being the primary cause of death. Median ISS was 34 (25-41.5) for lethal cases and 4 (2-16) for the overall patient group. Median NISS was 48 (43-57) for lethal cases and 6 (3-22) for the overall patient group. CONCLUSION Both ISS and NISS show comparable efficacy in predicting the likelihood of fatal outcomes.  RECOMMENDATIONS In specialized facilities, both signs could be routinely employed to evaluate patient status and prioritize the next steps in therapy