The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures
Category: Ankle, Trauma Introduction/Purpose: Metabolic syndrome (MetS) has been shown to be associated with significant post-operative morbidity. Despite an increasing prevalence of MetS in the US population, it’s impact on post-operative outcomes following ankle fractures remains limited. Methods:...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-10-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011419S00444 |
| _version_ | 1818208224707346432 |
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| author | Jack Xie BS Azeem Tariq Malik MBBS Carmen E Quatman MD, PhD Thuan V. Ly MD Laura Phieffer MD Safdar N Khan MD |
| author_facet | Jack Xie BS Azeem Tariq Malik MBBS Carmen E Quatman MD, PhD Thuan V. Ly MD Laura Phieffer MD Safdar N Khan MD |
| author_sort | Jack Xie BS |
| collection | DOAJ |
| description | Category: Ankle, Trauma Introduction/Purpose: Metabolic syndrome (MetS) has been shown to be associated with significant post-operative morbidity. Despite an increasing prevalence of MetS in the US population, it’s impact on post-operative outcomes following ankle fractures remains limited. Methods: The 2012-2016 ACS-NSQIP database was used to query for patients undergoing ORIF for ankle fractures using Current Procedural Terminology (CPT) codes – 27766, 27769, 27792, 27814, 27822 and 27823. Patient undergoing surgery for polytrauma were excluded from the analysis. Records were further filtered to remove patients with missing data. The study cohort was divided into two groups – MetS vs. No MetS. MetS was identified using a pre-defined criteria, used previously in other studies, as the co-existence of 1) Diabetes Mellitus, 2) Hypertension and 3) BMI =30 kg/m2. Results: A total of 1,013 (6.7%) MetS underwent ORIF for ankle fractures. Following adjustment for differences in baseline demographic, co-morbidities, pre-operative and operative data, MetS was an independent predictor of experiencing any 30-day complication (OR 1.35 [95% CI 1.05 -1.74]; p=0.020), wound complications (OR 1.67 [95% CI 1.07-2.60]; p=0.024), renal complications (OR 3.54 [95% CI 1.20-10.48]; p=0.022), 30-day readmissions (OR 1.66 [95% CI 1.24-2.22]; p=0.001), 30-day unplanned re-operations (OR 1.69 [95% CI 1.14-2.51]; p=0.009). MetS was significantly associated with decreased odds of home discharge (OR 0.66 [95% CI 0.54-0.79]; p<0.001). Conclusion: Patients with MetS undergoing ORIF for ankle fractures are at an increased risk of experiencing adverse complications, re-admissions and re-operations within 30-days of the surgery. Providers should understand the need of appropriate post-operative surveillance in this high-risk group to minimize the risk of poor outcomes. |
| first_indexed | 2024-12-12T04:41:25Z |
| format | Article |
| id | doaj.art-3137b26e9aa04d8c8d049763d92f5b11 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-12T04:41:25Z |
| publishDate | 2019-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-3137b26e9aa04d8c8d049763d92f5b112022-12-22T00:37:48ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142019-10-01410.1177/2473011419S00444The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle FracturesJack Xie BSAzeem Tariq Malik MBBSCarmen E Quatman MD, PhDThuan V. Ly MDLaura Phieffer MDSafdar N Khan MDCategory: Ankle, Trauma Introduction/Purpose: Metabolic syndrome (MetS) has been shown to be associated with significant post-operative morbidity. Despite an increasing prevalence of MetS in the US population, it’s impact on post-operative outcomes following ankle fractures remains limited. Methods: The 2012-2016 ACS-NSQIP database was used to query for patients undergoing ORIF for ankle fractures using Current Procedural Terminology (CPT) codes – 27766, 27769, 27792, 27814, 27822 and 27823. Patient undergoing surgery for polytrauma were excluded from the analysis. Records were further filtered to remove patients with missing data. The study cohort was divided into two groups – MetS vs. No MetS. MetS was identified using a pre-defined criteria, used previously in other studies, as the co-existence of 1) Diabetes Mellitus, 2) Hypertension and 3) BMI =30 kg/m2. Results: A total of 1,013 (6.7%) MetS underwent ORIF for ankle fractures. Following adjustment for differences in baseline demographic, co-morbidities, pre-operative and operative data, MetS was an independent predictor of experiencing any 30-day complication (OR 1.35 [95% CI 1.05 -1.74]; p=0.020), wound complications (OR 1.67 [95% CI 1.07-2.60]; p=0.024), renal complications (OR 3.54 [95% CI 1.20-10.48]; p=0.022), 30-day readmissions (OR 1.66 [95% CI 1.24-2.22]; p=0.001), 30-day unplanned re-operations (OR 1.69 [95% CI 1.14-2.51]; p=0.009). MetS was significantly associated with decreased odds of home discharge (OR 0.66 [95% CI 0.54-0.79]; p<0.001). Conclusion: Patients with MetS undergoing ORIF for ankle fractures are at an increased risk of experiencing adverse complications, re-admissions and re-operations within 30-days of the surgery. Providers should understand the need of appropriate post-operative surveillance in this high-risk group to minimize the risk of poor outcomes.https://doi.org/10.1177/2473011419S00444 |
| spellingShingle | Jack Xie BS Azeem Tariq Malik MBBS Carmen E Quatman MD, PhD Thuan V. Ly MD Laura Phieffer MD Safdar N Khan MD The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures Foot & Ankle Orthopaedics |
| title | The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures |
| title_full | The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures |
| title_fullStr | The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures |
| title_full_unstemmed | The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures |
| title_short | The Impact of Metabolic Syndrome on 30-day Outcomes Following ORIF for Ankle Fractures |
| title_sort | impact of metabolic syndrome on 30 day outcomes following orif for ankle fractures |
| url | https://doi.org/10.1177/2473011419S00444 |
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