SLR - May 2017 - Sara A. Naguib
Reference: Cavo MJ, Fox JP, Markert R, Laughlin RT. Association Between Diabetes, Obesity, and Short-Term Outcomes Among Patients Surgically Treated for Ankle Fracture. J Bone Joint Surg Am. 2015;97(12):987–94.Reviewed By: Sara A. Naguib, DPM
Residency Program: Temple University Hospital, Philadelphia, PA
Podiatric Relevance: Ankle fractures are a common injury that foot and ankle surgeons encounter on a daily basis. Many patients who suffer ankle fractures have comorbidities and risk factors, which put them at a higher risk for complications in the perioperative period. It is essential that surgeons evaluate these risk factors so that they can predict outcomes after surgery. This study specifically assessed patients with obesity and diabetes and whether these comorbidities are associated with more frequent complications, longer hospital stay and higher costs of care compared to patients without these comorbidities.
Methods: This retrospective review assessed adult patients who underwent surgical treatment for an isolated ankle fracture or dislocation. These patients were identified in the Nationwide Inpatient Sample from 2001 to 2010. They were divided into four groups depending on if s/he had obesity and/or diabetes. The aim was to determine the association between diagnostic group and in-hospital complications, length of stay at the hospital and costs of care.
Results: The frequency of in-hospital complications was 2.6 percent in patients without diabetes or obesity but increased to 4.2 percent, 5.3 percent and 6.5 percent for patients with obesity alone, diabetes alone and both diagnoses, respectively. Mean length of stay and hospital costs were greater for patients with diabetes and/or obesity compared to patients without these comorbidities.
Conclusions: Patients living with diabetes, obesity or both diagnoses who underwent operative treatment of ankle fractures had more frequent in-hospital complications, longer hospitalizations and higher hospital costs when compared with patients without these diagnoses. These results may be useful in predicting the perioperative outcomes in this particular group of patients and may aid hospitals in handling the care of this population.