Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Weill Cornell Medical College, New York City, NY, USA.
Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1751-1756. doi: 10.1007/s00590-022-03348-2. Epub 2022 Aug 9.
Femoral shaft fractures are common in the pediatric population, accounting for over 20% of inpatient pediatric fractures. Patients with developmental delays are a population group whose medical care and recovery come with a unique set of considerations and challenges. The purpose of this study was to evaluate the impact of developmental delay on outcomes following open treatment of femoral shaft fractures in the pediatric population.
Pediatric patients undergoing open treatment of femoral shaft fracture from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were divided into two groups: patients with developmental delay and patients without developmental delay. Patient demographics, comorbidities, and various postoperative outcomes were compared between the two groups using bivariate and multivariate analyses.
Of the 5896 pediatric patients who underwent open treatment of femoral shaft fracture, 5479 patients (92.9%) did not have developmental delay whereas 417 (7.1%) had developmental delay. Patients with developmental delay were more likely to have other medical comorbidities. Following adjustment on multivariable regression analysis to control for the baseline differences between the two groups, patients with developmental delay had an increased risk of readmission to the hospital (OR 4.762; p = 0.014).
Developmental delay in the pediatric population was found to be an independent risk factor for hospital readmission following open treatment of femoral shaft fractures. Taking these patients into special consideration when evaluating the optimal treatment plan can be beneficial to reduce the risks of readmission, which can decrease costs for both the patient and the hospital.
股骨干骨折在儿科人群中较为常见，占住院儿童骨折的 20%以上。发育迟缓患者是一个需要特殊考虑和面临挑战的群体，他们的医疗和康复都需要特别的关注。本研究旨在评估发育迟缓对儿科人群股骨干开放性骨折治疗后结局的影响。
在国家手术质量改进计划-儿科数据库中，确定了 2012 年至 2019 年接受股骨干开放性骨折治疗的儿科患者。将患者分为两组：发育迟缓组和无发育迟缓组。使用双变量和多变量分析比较两组患者的人口统计学、合并症和各种术后结局。
在 5896 例接受股骨干开放性骨折治疗的儿科患者中，5479 例（92.9%）无发育迟缓，417 例（7.1%）有发育迟缓。发育迟缓患者更有可能患有其他合并症。在多变量回归分析调整以控制两组间的基线差异后，发育迟缓患者的住院再入院风险增加（OR 4.762；p=0.014）。
在儿科人群中，发育迟缓被发现是股骨干开放性骨折治疗后住院再入院的独立危险因素。在评估最佳治疗方案时，考虑这些患者的特殊情况，有助于降低再入院风险，从而降低患者和医院的成本。
