<< Back to the abstract archive
Predictors of complications in operative hand fractures and dislocations: Analysis of the 2011-2013 ACS NSQIP databases
Fernando Ovalle MD, Christopher van Belle MD, Christie Schaeffer BS, Peter Stern MD
University of Cincinnati - Integrated Plastic Surgery Residency Program
2015-03-15
Presenter: Fernando Ovalle MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. 100% of the work on this project represents the original work of the residents involved. Approval is granted to proceed with submission.
Director Name: W. John Kitzmiller, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background: Hand fractures and dislocations are common problems seen by hand surgeons. This study characterizes the epidemiology of this patient population and examines predictors of 30-day complications in operative hand fractures and dislocations in the United States.
Methods: Using the 2011-2013 American College of Surgeons National Surgical Quality Improvement database, a retrospective review was performed using Current Procedural Terminology codes to identify patients undergoing repair of fractures and/or dislocations of the fingers and hand. Demographic and operative factors were studied using univariate and multivariate analyses to identify predictors of surgical and medical complications.
Results: A total of 2212 patients were identified. The mean age was 39.2 +/- 16.4 and 72.2% were male. The mean BMI was 25.1 +/- 8.9 and 88.5% of patients had an American Society of Anesthesiologists class of 1 or 2. There were 31.1% current smokers and 5.4% diabetics. 91.6% had outpatient surgery and 89.3% had repair of a single fracture/dislocation. There were 2.5% surgical and 0.2% medical complications. Age (aOR 1.03; p = 0.001), BMI (aOR 1.1; p = 0.003), pre-existing wound/infection (aOR 4.0; p = 0.005), as well as multiple fractures/dislocations (aOR 3.5; p < 0.001) were independent predictors of surgical complications. Operative time (aOR 1.02; p = 0.01) was an independent predictor of medical complications.
Conclusions: Using a large national database, this study characterizes the population undergoing operative hand fracture/dislocation repair and identifies several independent predictors of medical and surgical morbidity, calling attention to the importance of preoperative risk stratification.
