Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Foot and Ankle Surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Ankle Fractures
Reoperation
Diabetes Mellitus
Mortality
Odds Ratio
Confidence Intervals
Postoperative Period
Current Procedural Terminology
Quality Improvement
Ankle
Retrospective Studies
Databases

Keywords

  • 2
  • ankle fracture
  • complications
  • diabetes
  • length of stay
  • outcomes
  • retrospective cohort study

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{229d783f1ccd4080b2cda255ffdb0c0c,
title = "Increased Rates of Readmission, Reoperation, and Mortality Following Open Reduction and Internal Fixation of Ankle Fractures Are Associated With Diabetes Mellitus",
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 {\circledR} 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.",
keywords = "2, ankle fracture, complications, diabetes, length of stay, outcomes, retrospective cohort study",
author = "Liu, {Jennifer W.} and Junho Ahn and Raspovic, {Katherine Marie} and Liu, {George T} and Nakonezny, {Paul A} and Lavery, {Lawrence A} and Wukich, {Dane K}",
year = "2019",
month = "1",
day = "1",
doi = "10.1053/j.jfas.2018.09.023",
language = "English (US)",
journal = "Journal of Foot and Ankle Surgery",
issn = "1067-2516",
publisher = "Academic Press Inc.",

}

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 Marie

AU - Liu, George T

AU - Nakonezny, Paul A

AU - Lavery, Lawrence A

AU - Wukich, Dane K

PY - 2019/1/1

Y1 - 2019/1/1

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.

AB - 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.

KW - 2

KW - ankle fracture

KW - complications

KW - diabetes

KW - length of stay

KW - outcomes

KW - retrospective cohort study

UR - http://www.scopus.com/inward/record.url?scp=85061249246&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061249246&partnerID=8YFLogxK

U2 - 10.1053/j.jfas.2018.09.023

DO - 10.1053/j.jfas.2018.09.023

M3 - Article

C2 - 30760411

AN - SCOPUS:85061249246

JO - Journal of Foot and Ankle Surgery

JF - Journal of Foot and Ankle Surgery

SN - 1067-2516

ER -