Association Between Area Deprivation Index and Narcotic Prescriptions, Wound Complications, and Reoperation Rates after Soft Tissue Hand and Wrist Surgery.

BACKGROUND

The area deprivation index (ADI) is an outcome metric that quantifies socioeconomic status by stratifying neighborhoods based on zip code. The purpose of this study was to investigate the effect of national ADI rank on the amount of narcotics prescribed, wound complications, and reoperations after routine hand or wrist surgery.

METHODS

We conducted a retrospective review of adult patients undergoing routine hand or wrist soft tissue surgery between 2013 and 2022. Patients were included if they underwent routine hand or wrist surgeries. Patients were excluded for having concomitant lacerations, penetrating injuries, or fractures. Multivariable logistic regression was performed to determine whether national ADI is associated with the amount of narcotics prescribed, the incidence of wound complications, and reoperation rates after routine hand and wrist procedures independent of covariates.

RESULTS

We included 1389 patients. The mean age was 55 years and 65 % were female. The average national ADI rank was 65.6. The largest ADI decile group that was categorized was in the 70-79 rank (consistent with a highly economically disadvantaged group), with the national median being set at 50. Wound complications occurred in 2.9 % of patients (n = 40) and reoperations occurred in 2.5 % of patients (n = 35). Multivariable regression determined that national ADI rank was not associated with a difference in the amount of narcotics prescribed (P = .141), wound complications (P = .599), or reoperation rates (P = .141).

CONCLUSIONS

National ADI rank was not associated with a significant difference in the amount of narcotics prescribed, wound complications, or reoperation rates.