Purpose
A national surgical database was used to determine risk factors for complications
in patients undergoing open reduction internal fixation (ORIF) for distal radius fractures.
Methods
The American College of Surgeons National Surgical Quality Improvement Program database
for the 2006–2012 years was queried to identify all patients who underwent an ORIF
of a distal radius fracture based on Current Procedural Terminology codes 25607, 25608,
or 25609. The database is a statistically representative sample of prospectively collected
perioperative surgical data from hospitals primarily in the United States. Demographics,
comorbidities, preoperative laboratory values, and 30-day complications were compared
between the patient groups with and without a postoperative complication. Multivariate
analysis was performed to identify patient characteristics and comorbidities that
were independently associated with early postoperative complications.
Results
This retrospective analysis identified 3,003 patients who underwent an ORIF of the
distal radius over 7 years. The number of patients with a complication within 30 days
after surgery was 62 (2%), totaling 90 complications. Incidence of return to the operative
room for the entire study population was 1.1%. Multivariate analysis, adjusting for
confounding variables, showed that patients with a complication were more likely to
have hypertension, congestive heart failure, preoperative chemotherapy or radiotherapy,
longer operating time, and manifest preoperative impairment in independent living.
Conclusions
Approximately 2% of patients sustained a complication within 30 days following ORIF
of a distal radius fracture. Recognition of the risk factors may help avoid complications
in the identified high-risk patients.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Published online: October 28, 2014
Accepted:
September 5,
2014
Received:
June 16,
2014
Footnotes
C.S.P. is a paid consultant for Tournier and L.S.B. is a paid consultant for Trimed.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Commentary Regarding “Risk Factors for Complications Following Open Reduction Internal Fixation of Distal Radius Fractures” and “Risk Factors for 30-Day Postoperative Complications and Mortality Following Open Reduction Internal Fixation of Distal Radius Fractures”Journal of Hand SurgeryVol. 39Issue 12
- PreviewAs a direct consequence of national concern about the current and future economic impact of health care, many stakeholders have turned to “big data” as a means of answering important questions regarding, among many others, cost–benefit, risk–benefit, and quality improvement–best practice. The American College of Surgeons National Surgical Quality Improvement Program is one such repository of big data, and the authors of the 2 preceding articles1,2 have chosen to mine this database to answer almost the same question: the incidence of 30-day complications associated with open reduction internal fixation (ORIF) of distal radius fractures and, from these data, whether they could identify risk factors that could alter decision making.
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