Cole Sarah, Whitaker Sarah, O'Neill Conor, Satalich James, Ernst Brady, Kang Le, Hawila Rami, Satpathy Jibanananda, Kates Stephen
Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Department of Orthopaedic Surgery, Duke University Health System, Durham, NC, USA.
Arch Orthop Trauma Surg. 2024 Dec 18;145(1):70. doi: 10.1007/s00402-024-05726-3.
This retrospective cohort study aims to compare short-term complication rates between patients receiving open reduction and internal fixation (ORIF) for associated versus elementary acetabular fractures, with a secondary objective of identifying independent risk factors for adverse outcomes.
The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) codes to identify patients that underwent ORIF for associated acetabular (CPT 27228) or elementary acetabular fractures (CPT 27226, 27227) from 2010 to 2021. Propensity score matching was employed to account for baseline differences and the short-term complication rates were compared between the cohorts.
We identified 1,330 patients who underwent ORIF for an acetabular fracture between 2010 and 2021, including 868 patients with elementary fractures and 462 with associated fractures. After matching, there were 462 patients in each cohort. The matched associated acetabular fracture group experienced higher rates of any adverse event (AAE, p = 0.029), transfusion (p = 0.010), and reoperation (p = 0.049). Increased age, increased operative time, higher body mass index (BMI), and prolonged hospital length of stay (LOS) augmented the risk of any complication.
The findings of this study identify areas of greater risk of postoperative complications after ORIF in individuals with associated versus elementary acetabular fractures. Discussion of these heightened risks is critical to appropriate patient care. Understanding these risks plays an important role in the clinical decision-making process and may identify areas to monitor patients postoperatively.
本回顾性队列研究旨在比较接受切开复位内固定术（ORIF）治疗的合并髋臼骨折与单纯髋臼骨折患者的短期并发症发生率，次要目的是确定不良结局的独立危险因素。
使用当前手术操作术语（CPT）编码查询美国外科医师学会（ACS）国家外科质量改进计划（NSQIP）数据库，以识别2010年至2021年期间接受ORIF治疗合并髋臼骨折（CPT 27228）或单纯髋臼骨折（CPT 27226、27227）的患者。采用倾向评分匹配法来考虑基线差异，并比较队列之间的短期并发症发生率。
我们确定了2010年至2021年期间1330例接受髋臼骨折ORIF治疗的患者，其中868例为单纯骨折患者，462例为合并骨折患者。匹配后，每个队列中有462例患者。匹配后的合并髋臼骨折组任何不良事件（AAE，p = 0.029）、输血（p = 0.010）和再次手术（p = 0.049）的发生率更高。年龄增加、手术时间延长、体重指数（BMI）较高和住院时间延长会增加任何并发症的风险。
本研究结果确定了合并髋臼骨折与单纯髋臼骨折患者在接受ORIF术后并发症风险较高的领域。讨论这些较高的风险对于适当的患者护理至关重要。了解这些风险在临床决策过程中起着重要作用，并可能确定术后监测患者的领域。
