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Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus.
J Foot Ankle Surg. 2019 May; 58(3):470-474.JF

Abstract

The purpose of this study was to compare the rates of readmission, reoperation, and mortality in patients with and without diabetes mellitus during the 30-day postoperative period after ankle fracture surgery. Patients who underwent operative management for ankle fractures between 2006 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program® database by using Current Procedural Terminology codes for ankle fracture surgery. A total of 17,464 patients undergoing ankle fracture surgery were identified. Of these patients, 2044 (11.7%) had diabetes and 15,420 (88.3%) did not have diabetes. We excluded patients older than 90 years or with inadequate perioperative data. Patients with diabetes had significantly higher rates of readmission (2.84% vs 1.05%, p < .0001), significantly higher rates of unplanned reoperation (2.3% vs 0.74%, p < .0001), and significantly higher rates of mortality (0.7% vs 0.2%, p < .0001) compared with patients without diabetes. Additionally, patients with diabetes had significantly greater age-adjusted odds ratios (ORs) of unplanned readmission (OR 2.40, 95% confidence interval [CI] 1.74 to 3.31, p < .0001), unplanned reoperation (OR 2.56, 95% CI 1.44 to 3.27, p < .0001), and mortality (OR 2.01, 95% CI 1.08 to 3.62, p = .0432) than did patients without diabetes after ankle surgery. In this large-scale retrospective study, we demonstrated that the presence of diabetes significantly increases the risk of unplanned readmission, unplanned reoperation, and mortality during the 30-day postoperative period after ankle fracture surgery.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX.Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Dane.Wukich@utsouthwestern.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30760411

Citation

Liu, Jennifer W., et al. "Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus." The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, vol. 58, no. 3, 2019, pp. 470-474.
Liu JW, Ahn J, Raspovic KM, et al. Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus. J Foot Ankle Surg. 2019;58(3):470-474.
Liu, J. W., Ahn, J., Raspovic, K. M., Liu, G. T., Nakonezny, P. A., Lavery, L. A., & Wukich, D. K. (2019). Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus. The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, 58(3), 470-474. https://doi.org/10.1053/j.jfas.2018.09.023
Liu JW, et al. Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus. J Foot Ankle Surg. 2019;58(3):470-474. PubMed PMID: 30760411.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus. AU - Liu,Jennifer W, AU - Ahn,Junho, AU - Raspovic,Katherine M, AU - Liu,George T, AU - Nakonezny,Paul A, AU - Lavery,Lawrence A, AU - Wukich,Dane K, Y1 - 2019/02/11/ PY - 2018/08/04/received PY - 2019/2/15/pubmed PY - 2019/2/15/medline PY - 2019/2/15/entrez KW - ankle fracture KW - complications KW - diabetes KW - length of stay KW - outcomes KW - retrospective cohort study SP - 470 EP - 474 JF - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons JO - J Foot Ankle Surg VL - 58 IS - 3 N2 - The purpose of this study was to compare the rates of readmission, reoperation, and mortality in patients with and without diabetes mellitus during the 30-day postoperative period after ankle fracture surgery. Patients who underwent operative management for ankle fractures between 2006 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program® database by using Current Procedural Terminology codes for ankle fracture surgery. A total of 17,464 patients undergoing ankle fracture surgery were identified. Of these patients, 2044 (11.7%) had diabetes and 15,420 (88.3%) did not have diabetes. We excluded patients older than 90 years or with inadequate perioperative data. Patients with diabetes had significantly higher rates of readmission (2.84% vs 1.05%, p < .0001), significantly higher rates of unplanned reoperation (2.3% vs 0.74%, p < .0001), and significantly higher rates of mortality (0.7% vs 0.2%, p < .0001) compared with patients without diabetes. Additionally, patients with diabetes had significantly greater age-adjusted odds ratios (ORs) of unplanned readmission (OR 2.40, 95% confidence interval [CI] 1.74 to 3.31, p < .0001), unplanned reoperation (OR 2.56, 95% CI 1.44 to 3.27, p < .0001), and mortality (OR 2.01, 95% CI 1.08 to 3.62, p = .0432) than did patients without diabetes after ankle surgery. In this large-scale retrospective study, we demonstrated that the presence of diabetes significantly increases the risk of unplanned readmission, unplanned reoperation, and mortality during the 30-day postoperative period after ankle fracture surgery. SN - 1542-2224 UR - https://www.unboundmedicine.com/medline/citation/30760411/Increased_Rates_of_Readmission_Reoperation_and_Mortality_Following_Open_Reduction_and_Internal_Fixation_of_Ankle_Fractures_Are_Associated_With_Diabetes_Mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1067-2516(18)30427-7 DB - PRIME DP - Unbound Medicine ER -