Ten-year National Trends in Patient Characteristics and 30-day Outcomes of Distal Radius Fracture Open Reduction and Internal Fixation

Abstract

Introduction: Despite increased utilization, recent temporal trends in patient comorbidities and episode-of-care outcomes for distal radius fracture open reduction and internal fixation (ORIF) have not been studied. The objective of this study was to assess 10-year national trends in (1) patient characteristics and comorbidities and (2) 30-day postoperative adverse outcomes for patients who underwent distal radius fracture ORIF using a large patient database. Methods: A retrospective study was conducted using the National Surgical Quality Improvement Program database by querying the procedural codes for distal radius fracture ORIF from January 1, 2011, to December 31, 2020. A cohort of 28,616 adult patients who underwent distal radius fracture ORIF during the study period was included. Baseline patient characteristics and 30-day postoperative outcome data were collected for each year of the study. Temporal trends from 2011 to 2020 for all variables were assessed using the twotailed Mann-Kendall trend test. Results: Of the 28,616 patients in the study cohort, the mean age was 56.4 years and 73.1% were female. Demographically, there was a trend toward higher body mass index, higher American Society of Anesthesiologists classification, and lower proportions of active smokers; functionally dependent patients; and patients with hypertension, chronic obstructive pulmonary disease, and bleeding disorder. There was a trend toward worse sepsis physiology and wound classification on presentation. There was a trend toward fewer blood transfusions, hospital readmissions, and revision surgeries; however, there was an increasing trend for the development of a superficial surgical site infection. Discussion: Ten-year national trends in distal radius fracture ORIF demonstrated improvements in several important patient comorbidities and the rates of readmission and revision surgery.

Outcomes Following Surgical Fixation of Distal Radius Fractures in Patients With Chronic Kidney Disease

“… 13 Interestingly, 30- and 90-day readmission rates were no different in both groups and are within reported ranges of readmission rates following operative distal radius fractures. 14 , 15 , 16 Patients with CKD are shown to have higher readmission rates and mortality following lower extremity fracture care compared with patients without kidney disease. 17 The additional impact of kidney disease on frailty scores in patients with CKD could be a contributing factor to the observed higher mortality rate and should perhaps be taken into account when managing these injuries.…”