Elective Surgical Care Pathways Are Associated With Lower Fracture Rates at Presentation and Contribute to Superior Clinical Outcomes in Metastatic Bone Disease - Report - MDSpire
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Surgical Care Pathways for Elective Procedures Linked to Reduced Fracture Incidence and Improved Outcomes in Patients with Metastatic Bone Disease

  • By

  • Annalise G Abbott

  • Joseph K. Kendal

  • Benjamin Wajda

  • Golpira Elmi Assadzadeh

  • Shannon K. T. Puloski

  • Michael J. Monument

  • June 1, 2026

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Surgical Care Pathways for Elective Procedures Linked to Reduced Fracture Incidence

Overview

This study compares outcomes between elective and emergent surgical pathways for patients with metastatic bone disease (MBD).

Background

Metastatic bone disease significantly affects the quality of life in cancer patients, leading to complications such as pathologic fractures and impaired mobility. As the prevalence of MBD rises due to advances in cancer care, this study aims to compare surgical care pathways on patient outcomes.

Data Highlights

OutcomeElective SurgeryEmergent Surgery
Overall SurvivalImprovedInferior
Length of StayReducedLonger
30-Day Readmission Rate6.1%12.2%

Key Findings

  • Elective surgical pathways are linked to improved overall survival in MBD patients.
  • Patients undergoing elective surgery had a lower length of stay compared to those undergoing emergent surgery.
  • The 30-day readmission rate was significantly lower in the elective group (6.1%) versus the emergent group (12.2%).
  • Emergent surgery is associated with higher mortality rates compared to elective procedures.
  • Care pathway analysis can help refine surgical care delivery for patients with MBD.

Clinical Implications

Clinicians should consider the differences in outcomes between elective and emergent surgical pathways for MBD patients.

Conclusion

This study compares the outcomes of elective versus emergent surgical pathways in managing metastatic bone disease.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. BJS (British Journal of Surgery) — Optimizing Perioperative Management for Surgical Patients in the Elderly Population
  3. Archives of Orthopaedic and Trauma Surgery — Association between timing of surgery and postoperative outcomes in older adults with distal femur fractures: a systematic review and meta-analysis
  4. keck medicine of usc — Bone Metastasis Happens in Up to 50% of Advanced Cancer Cases. Is Treatment Improving?
  5. baptist health south florida — Bone Health and Fracture Prevention for Orthopedic Referrals
  6. BOAST Metastatic Bone Disease Guidelines
  7. Radiotherapy of bone metastases: 2025 update
  8. Implementation of ERAS pathway in spinal metastases surgery
  9. Elective Surgical Care Pathways Are Associated With Lower Fracture Rates at Presentation and Contribute to Superior Clinical Outcomes in Metastatic Bone Disease - Abbott - Journal of Surgical Oncology - Wiley Online Library
  10. Survival impact of pathological fractures in metastatic cancer: a comprehensive meta-analysis - PubMed
  11. Postoperative survival in patients undergoing surgery for long bone metastases: a systematic review and Meta-analysis of outcomes across primary tumor types - PMC
  12. External validation of 12 existing survival prediction models for patients with spinal metastases - ScienceDirect
  13. Frontiers | Fracture risk and survival outcomes of radium-223 therapy for bone metastases in mCRPC and the modulatory role of bone-protective therapy: a systematic review and meta-analysis

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