Length of stay and 30-day readmissions after isolated humeral shaft fracture open reduction and internal fixation compared to intramedullary nailing

•Humerus shaft fractures are commonly treated with open reduction and internal fixation (ORIF) or intramedullary nailing (IMN).•30-day readmission rate after each of these procedures is unknown.•We demonstrate no significant difference in 30-day readmission between ORIF and IMN for humerus shaft fra...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Injury 2020-04, Vol.51 (4), p.942-946
Hauptverfasser: Merrill, Robert K, Low, Sara L, Arvind, Varun, Whitaker, Colin M, Illical, Emmanuel M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:•Humerus shaft fractures are commonly treated with open reduction and internal fixation (ORIF) or intramedullary nailing (IMN).•30-day readmission rate after each of these procedures is unknown.•We demonstrate no significant difference in 30-day readmission between ORIF and IMN for humerus shaft fracture fixation. Open reduction with internal fixation (ORIF) and intramedullary nailing (IMN) have similar union rates for treating humerus shaft fractures, but IMN leads to increased incidence of shoulder impingement and reoperation. The difference in 30-day readmission rate and length of stay (LOS) between these procedures is unknown. The objective of the study was to compare 30-day unplanned readmissions and length of stay between humeral shaft fractures fixed with either ORIF or IMN. The nationwide readmissions database (NRD) was queried for patients with humeral shaft fractures treated with ORIF or IMN between 2015–2016. IMN cases were propensity matched to ORIF cases based on demographic and co-morbid variables. Multivariable logistic regression determined if treatment modality was an independent risk factor for 30-day readmission or length of stay >3 days. There were 406 patients treated with IMN matched to 406 patients treated with ORIF. The 30-day readmission rate was 6.4% for IMN and 4.9% for ORIF (p = 0.45), and the median LOS was 3 days for each group (p = 0.45). Congestive heart failure (CHF)(OR=2.7, p = 0.04), depression (OR=3.3, p = 0.0008), and electrolyte abnormality (OR=3.6, p = 0.0003) were independent risk factors for readmission. Older age (OR=1.02, p = 0.03), CHF (OR=2.4, p = 0.03), electrolyte abnormality (OR=2.6, p = 0.0001), obesity (OR=2.8, p3 days. Comorbid conditions are risk factors for 30-day readmission and increased LOS. Comorbidity, discharge disposition, and open fractures are risk factors for increased LOS. Treating humeral shaft fractures with either ORIF or IMN did not affect readmission or length of stay.
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2020.02.001