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比较切开复位内固定治疗髋臼骨折后再入院患者的人口统计学特征和患者特定的危险因素。

Comparison of patient demographics and patient-specific risk factors for readmissions following open reduction and internal fixation for acetabular fractures.

机构信息

Department of Orthopedic Surgery, Maimonides Medical Center, 927 49th St., Brooklyn, NY, 11219, USA.

College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA.

出版信息

Eur J Orthop Surg Traumatol. 2024 May;34(4):1911-1915. doi: 10.1007/s00590-024-03862-5. Epub 2024 Mar 9.

Abstract

PURPOSE

Acetabular fractures are highly complex injuries often resulting from high-energy trauma. The gold standard treatment for these injuries has become open reduction internal fixation (ORIF). The purpose of this study is to further this understanding and investigate how (1) patient demographics and (2) patient-specific risk factors affect 90-day readmission rates.

METHODS

A retrospective, nationwide query of private insurance database from January 1st, 2010 to October 31st, 2020 was performed using ICD-9, ICD-10, and CPT codes. Patients who underwent acetabular ORIF and were readmitted within 90 days following index procedure were included, patients who were not readmitted served as controls. Patients were divided by demographics and specific risk factors associated with readmission.

RESULTS

The query yielded a total of 3942 patients. Age and sex were found to be non-significant contributing risk factors to 90-day readmissions. Data also showed that statistically significant comorbidities included arrhythmia, cerebrovascular disease, coagulopathy, fluid and electrolyte abnormalities, and pathologic weight loss.

CONCLUSION

This study illustrated how several patient-specific risk factors may contribute to increased 90-day readmission risk following acetabular ORIF. A heightened awareness of these comorbidities in patients requiring acetabular ORIF is required to improve patient outcomes and minimize rates of readmission. Further investigation is needed to improve patient outcomes, and increase awareness of potential post-operative complications in these higher-risk patient populations.

摘要

目的

髋臼骨折是一种复杂的损伤,通常由高能创伤引起。这些损伤的金标准治疗方法已成为切开复位内固定术(ORIF)。本研究的目的是进一步了解这些损伤,并研究(1)患者人口统计学特征和(2)患者特定的危险因素如何影响 90 天再入院率。

方法

对 2010 年 1 月 1 日至 2020 年 10 月 31 日的私人保险数据库进行了回顾性全国性查询,使用了 ICD-9、ICD-10 和 CPT 代码。纳入接受髋臼 ORIF 且在索引手术后 90 天内再次入院的患者,未再入院的患者作为对照。根据人口统计学特征和与再入院相关的特定危险因素对患者进行分组。

结果

查询共产生了 3942 名患者。年龄和性别被发现与 90 天再入院无显著相关性。数据还表明,统计上显著的合并症包括心律失常、脑血管病、凝血功能障碍、液体和电解质异常以及病理性体重减轻。

结论

本研究说明了几个患者特定的危险因素可能导致髋臼 ORIF 后 90 天再入院风险增加。在需要髋臼 ORIF 的患者中,需要提高对这些合并症的认识,以改善患者的预后并降低再入院率。需要进一步研究以改善患者的预后,并提高对这些高风险患者群体潜在术后并发症的认识。

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