附肢骨转移性肿瘤的手术是肢体功能和生存之间的权衡。来自一家高度专业化中心的先前研究发现，扩大手术不会增加30天的死亡风险，并推测广泛切除和重建可能会减少术后死亡率。该研究旨在调查手术创伤的参数（失血量、手术持续时间和骨切除程度）是否会对人群基础队列中接受端修复（EPR）或内固定（IF）治疗的患者的30天死亡风险造成影响。 回顾性评估了2014年至2019年丹麦首都地区进行EPR / IF治疗的骨转移性附肢骨病人的基础队列。采用 Logistic 回归分析评估术中变量和患者特征与30天死亡率的关联。使用Kaplan-Meier估计法评估无随访丢失的存活率。 共有437例患者进行了EPR / IF的附肢骨手术。描述手术创伤程度的参数（失血量/手术持续时间/骨切除程度）与死亡率无关。总体30天生存率为85％（95％置信区间[CI]为81-88）。单变量分析发现ASA 3+4组、Karnofsky评分<70、快速生长的原发性癌症、内脏和多骨转移为30天死亡的危险因素。多变量分析中，男性（OR 2.8, CI 1.3-6.3）、Karnofsky评分<70（OR 4.2, CI 2.1-8.6）和多发骨转移（OR 3.4, CI 1.2-9.9）是30天死亡的独立预后因素。 手术创伤的参数与30天死亡率无关，而是总体健康状况和原发性癌症程度影响了手术后的生存。

Surgery for bone metastases in the appendicular skeleton (aBM) is a trade-off between limb function and survival. A previous study from a highly specialized center found that extended surgery is not a risk for 30-day mortality and hypothesized that wide resection and reconstruction might reduce postoperative mortality. The study aimed to investigate whether parameters describing the surgical trauma (blood loss, duration of surgery, and degree of bone resection) pose a risk for 30-day mortality in patients treated with endoprostheses (EPR) or internal fixation (IF) in a population-based cohort.A population-based cohort having EPR/IF for aBM in the Capital Region of Denmark 2014-2019 was retrospectively assessed. Intraoperative variables and patient demographics were evaluated for association with 30-day mortality by logistic regression analysis. Kaplan-Meier estimate was used to evaluate survival with no loss to follow-up.437 patients had aBM surgery with EPR/IF. No parameters describing the magnitude of the surgical trauma (blood loss/duration of surgery/degree of bone resection) were associated with mortality. Overall 30-day survival was 85% (95% confidence interval [CI] 81-88). Univariate analysis identified ASA group 3+4, Karnofsky score < 70, fast-growth primary cancer, and visceral and multiple bone metastases as risk factors for 30-day mortality. Male sex (OR 2.8, CI 1.3-6.3), Karnofsky score < 70 (OR 4.2, CI 2.1-8.6), and multiple bone metastases (OR 3.4, CI 1.2-9.9) were independent prognostic factors for 30-day-mortality in multivariate analysis.The parameters describing the surgical trauma were not associated with 30-day mortality but, instead, general health status and extent of primary cancer influenced survival post-surgery.