Clinical Outcomes and Surgical Complications Among Patients with Bleeding Disorders After Acute Hip Fracture Surgery

Darbandi, Aria; Saadat, Ghulam H; Butler, Bennet A.; Bokhari, Faran

doi:10.1097/bot.0000000000002212

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…[46][47][48] Bleeding disorders have been associated with increased risk of major postoperative complications and need for postoperative blood transfusion. 43,49 Dialysis dependency has been associated with greater risk of in-hospital mortality, longer postoperative stay, and reoperations. 44,45 Chronic steroid use has been associated with increased risk for major, minor, and infectious complications in patients undergoing various orthopaedic procedures.…”

Section: Discussionmentioning

confidence: 99%

Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?

Chinta

Fisher

Tejwani

2023

Journal of Orthopaedic Trauma

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Objective: To assess the ability of a modified frailty index (mFI-5) score, which includes the presence of congestive heart failure, hypertension, chronic obstructive pulmonary disease, diabetes, and nonindependent functional status, and to identify patients at increased risk of complications after surgical treatment of long-bone nonunions/malunions. Design: Retrospective. Setting: Hospitals participating in the 2005–2018 American College of Surgeons National Surgical Quality Improvement Program. Patients/Participants: Patients in the American College of Surgeons National Surgical Quality Improvement Program database with upper extremity and lower extremity fractures were enrolled. Intervention: Surgical repair of nonunions/malunions of upper and lower extremity long bones. Main Outcome Measure: Postoperative complications after long-bone nonunion/malunion surgery. Results: Respective univariate analysis of the 2964 UE [1786 (60.3%) with mFI-5 of 0 and 386 (13.0%) with mFI-5 ≥2] and 3305 LE [1837 (55.6%) with mFI-5 of 0 and 498 (15.1%) with mFI-5 ≥2] showed that increasing mFI-5 score was associated with medical complications, extended longer length of stay, adverse discharge, and readmission. Binomial logistic regression showed that UE patients with mFI-5 ≥2 had increased risk of wound complications [odds ratio (OR) 2.512, 95% (confidence interval) CI: 1.037–6.086, P = 0.041), adverse discharge (OR 1.735, 95% CI: 1.204–2.499, P = 0.003), and unplanned readmission (OR 2.102, 95% CI: 1.038–4.255, P = 0.039), while LE patients with mFI-5 ≥2 had an increased risk of medical complications (OR 1.847, 95% CI: 1.307–2.610, P = 0.001), cumulative morbidity (OR 1.835, 95% CI: 1.342–2.510, P < 0.001), extended longer length of stay (OR 1.809, 95% CI: 1.233–2.654, P = 0.002), and adverse discharge (OR 1.841, 95% CI: 1.394–2.432, P < 0.001). Conclusions: mFI-5 score ≥2 is associated with significant increase in postoperative complications after surgical repair of long-bone nonunions/malunions. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?

Chinta

Fisher

Tejwani

2023

Journal of Orthopaedic Trauma

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Factors Associated With 30-Day Morbidity and Mortality Following the Surgical Treatment of Olecranon Fractures

Zhang¹,

Blazar²,

Earp³

2023

Orthopedics

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The objective of this study was to identify factors independently associated with complications, hospital readmission, reoperation, and death in the 30-day period after surgical treatment of isolated olecranon fractures. A retrospective case-control study was performed using the National Surgical Quality Improvement Program database by querying the Current Procedural Terminology code for patients who underwent surgical treatment of isolated olecranon fractures from 2011 to 2020. A total of 4404 patients were included. The main study outcomes were 30-day medical or wound complications, hospital readmission, reoperation, and death. A bivariate screen was performed for explanatory variables associated with our outcome variables, and variables with P <.1 in the bivariate screen were included in multivariable regression models. Of the 4404 patients in our cohort, 29 patients (0.7%) developed medical or wound complications, 157 patients (3.6%) were readmitted, 123 patients (2.8%) underwent reoperation, and 12 patients (0.3%) died during the 30-day postoperative period. Multivariable logistic regression analysis showed that older age, smoking, bleeding disorders, and higher American Society of Anesthesiologists classification were associated with readmission; that older age, bleeding disorders, and higher American Society of Anesthesiologists classification were associated with reoperation; and that bleeding disorders were associated with mortality. No identifiable factors were independently associated with medical or wound complications. In this National Surgical Quality Improvement Program database study of olecranon fractures treated surgically during a recent 10-year period, we identified demographic and comorbid factors independently associated with 30-day postoperative readmission, reoperation, and mortality. Our findings are relevant for preoperative risk stratification and counseling. [ Orthopedics . 202x;4x(x):xx–xx.]

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Clinical Outcomes and Surgical Complications Among Patients with Bleeding Disorders After Acute Hip Fracture Surgery

Abstract: Objective: To compare short-term (#30 days) outcomes of hip fracture between patients with and without bleeding disorders.

Cited by 2 publications

References 39 publications

Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?

Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?

Factors Associated With 30-Day Morbidity and Mortality Following the Surgical Treatment of Olecranon Fractures

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