Medical University of South Carolina, Charleston, SC, USA.
Southern Illinois University, Springfield, Ill, USA.
Hand (N Y). 2022 Mar;17(2):319-325. doi: 10.1177/1558944720915716. Epub 2020 Apr 27.
Distal radius fractures (DRFs) are the most common upper extremity fractures with more than 600 000 cases per year in the United States and account for up to 18% of fractures in the geriatric population. The purpose of our study was to identify the influence of age on 30-day postoperative outcomes while adjusting for patient demographics and comorbidities. The National Surgery Quality Improvement Program database was queried for patients having undergone open reduction internal fixation (ORIF) of DRFs. Current Procedural Terminology codes 25607, 25608, and 25609 between the years 2007 and 2016 were collected and analyzed. Patients were divided into 2 groups: group 1, 18 to 64 years; and group 2, 65 years and older. Patient demographics; preoperative, perioperative, and postoperative variables; and complications were recorded and analyzed. In all, 5894 patients were identified; group 1 consisted of 4056 patients aged <64 years, and group 2 consisted of 1838 patients aged 65 years and older. The total complication rate was 2.7% for all patients, 2.2% for group 1, and 3.4% for group 2. The most common complications included surgical site infection for group 1 and urinary tract infection for group 2. Univariate analysis demonstrated association between age ≥65 years and complication (hazard ratio, 1.55; 95% confidence interval, 1.12-2.14; = .009). However, after controlling for statistically significant factors, age was not an independent predictor of complications ( = .685). Admission status, American Society of Anesthesiologists classification, operative time, renal failure, and bleeding disorders were independent predictors of 30-day complications across all patients. Our data suggest that patients aged 65 years and older without high-risk comorbidities should be offered ORIF of DRFs as their complication risk remains low.
桡骨远端骨折（DRF）是美国最常见的上肢骨折，每年超过 600,000 例，占老年人群骨折的 18%。我们研究的目的是确定年龄对 30 天术后结果的影响，同时调整患者人口统计学和合并症。从国家手术质量改进计划数据库中查询接受桡骨远端骨折切开复位内固定术（ORIF）的患者。在 2007 年至 2016 年期间收集并分析了 25607、25608 和 25609 的当前程序术语代码。患者分为两组：组 1，18 至 64 岁；组 2，65 岁及以上。记录并分析了患者人口统计学资料、术前、围手术期和术后变量以及并发症。共确定了 5894 例患者；组 1 由 4056 名年龄<64 岁的患者组成，组 2 由 1838 名年龄 65 岁及以上的患者组成。所有患者的总并发症发生率为 2.7%，组 1 为 2.2%，组 2 为 3.4%。最常见的并发症包括组 1 的手术部位感染和组 2 的尿路感染。单因素分析表明，年龄≥65 岁与并发症之间存在关联（危险比，1.55；95%置信区间，1.12-2.14；P =.009）。然而，在控制了统计学上显著的因素后，年龄不是并发症的独立预测因素（P =.685）。入院状态、美国麻醉师协会分类、手术时间、肾衰竭和出血性疾病是所有患者 30 天并发症的独立预测因素。我们的数据表明，年龄≥65 岁且无高危合并症的患者应接受 DRF 的 ORIF，因为他们的并发症风险仍然较低。
