Operative care rates of lateral compression type 1 pelvic fractures increased from 2003 to 2018.

PURPOSE: To investigate trends in operative management of LC1 pelvic fractures and potential effects on hospital length of stay, home discharge, and mortality.

METHODS

The National Inpatient Sample (NIS) was queried and identified 43,743 older adults aged ≥ 60 years and 29,024 younger adults aged 18-59 years who had LC1 fractures via ICD diagnosis codes (2003-2018). Operative management was classified by ICD procedure codes for internal and/or external fixation. Adjusted annual change in rate of operative care, length of stay, mortality, and home discharge were assessed using multivariable robust Poisson regression models.

RESULTS

Operative care was provided to 1413 (3.2%) older adults and 5871 (20.2%) younger adults. Among older adults, operative care increased 5% per year (RR per year: 1.05, 95% CI 1.03-1.06, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), home discharge (RR per year: 0.99, 95% CI 0.99-1.00, p = 0.02) and mortality (RR per year: 0.95, 95% CI 0.95-0.96, p < 0.001). Among younger adults, operative care increased 2% per year (RR per year: 1.02, 95% CI 1.01-1.02, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), and mortality (RR per year: 0.95, 95% CI 0.94-0.96, p < 0.001).

CONCLUSION

Operative care of LC1 fractures in the United States increased from 2003 to 2018. A rise in operative care was associated with decreases in length of stay and mortality in older and younger adults, but fewer home discharges for older adults.

LEVEL OF EVIDENCE: Level III Therapeutic.