The Impact of Demographic Factors and Comorbidities on Distal Radius Fracture Outcomes

Abstract

Background Despite the prevalence and consequences of distal radius fracture (DRF), there is limited research that analyzes the effects of demographic factors and comorbidities as they relate to pain, perceived disability, and functional outcomes. Methods All data for this study were examined retrospectively within an established clinical database. Patients with DRF were evaluated during their first and final visits with a criterion-based numeric pain scale (CR12), the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, and a global rate of change scale to assess outcomes of pain, perceived disability, and function, respectively. Results The number of days between injury and initial therapy evaluation were inversely correlated with changes in perceived pain and perceived disability (r =−0.315, p =0.000; r =−0.348, p =0.000). In addition, moderate and statistically significant correlations were noted between work status and average CR12 and DASH scores at final re-evaluation (r =0.392, p =0.000, r =0.473, p =0.000). No significant relationships were noted between additional demographic factors or comorbidities and pain, perceived disability, or function during statistical analysis. Conclusions Patients without diabetes, hypertension, or depression and those who were not smokers had better outcomes in terms of pain, perceived disability, and function in this study. In addition, earlier timing of initial evaluation after injury and full duty work status were significantly related to improvement in pain and perceived disability. Timing of initiation of therapy and return to work are suggested as avenues for future research.Keywords Distal radius fracture . Outcomes . Comorbidities . Demographic factors Distal radius fracture (DRF) can have a severe impact on a person's quality of life by limiting range of motion in the wrist and the ability to complete daily tasks such as dressing, toileting, grooming, and feeding. When a person sustains a DRF, the primary symptoms include edema, pain, and deformity, along with poor range of motion, strength, and dexterity [10]. DRF accounts for one sixth of all fractures in patients over the age of 50 and are the most frequent fractures in the upper limb [1]. Furthermore, up to one fifth of all patients with a DRF have been reported to experience residual symptoms such as pain, nerve symptoms, and disability after 1 year [16]. Despite the prevalence and consequences of this diagnosis, there is limited research that analyzes the effects of demographic factors and comorbidities as they relate to pain, perceived disability, and functional outcomes following DRF.Numerous demographic factors and comorbidities have been previously suggested as intervening variables in the study of fracture outcomes. Gender and age have been identified as variables that may affect the healing process [14,18], while earlier return to function has been correlated with both injury to the dominant hand [2,3] and earlier referral to therapy [27]. Comorbidities including depression, smoking,...

Epidemiology of distal radius fractures and factors predicting risk and prognosis

“…A few studies with short-term follow-up (6 or 12 months) reported that sex/gender has no influence on pain and disability experienced after DRF treated either operatively or nonoperatively. 18,64,78,79 In contrast, recent studies reported that women had higher levels of residual pain, 75 disability, 68 and poor function 80 among patients with postoperative DRF such that elderly women had greater disability compared with elderly men; however, quality of life did not differ. 68 Similarly, there is lack of consensus around the role of sex/gender on mortality rates after DRF.…”

Utilization of Post-Acute Care Following Distal Radius Fracture Among Medicare Beneficiaries

“…Many DRF patients experience noteworthy pain and disability during recovery, particularly those patients with multiple comorbidities, and post-acute care could ease recovery. (37) For many conditions, post-acute care is one of the largest contributors of variation in Medicare payments to hospitals around episodes of surgery care and one of the fastest growing categories of healthcare expenditures. (38) Furthermore, bundled payment and shared savings programs are directed to provide stronger incentives to improve recovery from common, acute conditions in a cost-efficient manner.…”

The Effect of Socioeconomic Factors on Outcomes of Distal Radius Fractures: A Systematic Review

“…Furthermore, the number of days between injury and initial therapy evaluation were inversely correlated with changes in perceived pain and disability as measured by the criterionbased numeric pain scale (CR12) and DASH questionnaire (r = −0.315 and −0.348, respectively; P = .000 for both). 36 A prospective study found that injury compensation was the most influential predictor of pain and disability at 1 year (P = .006) 10 and that those who completed postsecondary training had lower PRWE and DASH scores than those who did not (P = .016). 10 Worker's compensation has also been found to be strongly associated with pain (visual analog scale [VAS] score; regression coefficient, 3.1; 95% CI, 2.15-4.1) and function (regression coefficient = 16.5; 95% CI, 8.7-24.3) in a retrospective review of DRF patients.…”