Risk Factors for Infections Following Open Reduction and Internal Fixation for Distal Radius Fractures An Analysis of the Medicare Claims Database.

UNLABELLED: Bulletin of the Hospital for Joint Diseases 2022;80(2):228-33228 Mahmood B, Golub IJ, Ashraf AM, Ng MK, Vakharia RM, Choueka J. Risk factors for infections following open reduction and internal fixation for distal radius fractures: an analysis of the medicare claims database. Bull Hosp Jt Dis. 2022;80(2):228-33. Abstract

Background

Infections following open reduction and internal fixation (ORIF) of distal radius fractures (DRFs) are associated with worse outcomes and increasing health care costs. The purpose of this study was to utilize a nationwide administrative claims database to compare patient demo- graphics of patients who did and did not develop infections and identify patient-related risk factors for postoperative infections.

METHODS

Using the PearlDiver database, the 100% Medicare Files from 2005 to 2014 were queried. Patients undergoing ORIF for DRF were identified using Current Procedural Terminology (CPT) codes. Inclusion for the study group consisted of patients who developed infection within 90 days after the procedure and were identified us- ing CPT and International Classification of Disease, Ninth Revision (ICD-9) codes. Multivariable binomial logistic regression analyses were performed to calculate the odds (OR) of certain patient comorbidities and their association with infection following ORIF of DRFs. A p-value less than 0.002 was considered statistically significant after Bonfer- roni correction.

RESULTS

The query yielded 132,650 patients within the study, 456 who developed surgical site infections (SSI) and 132,194 who did not. Surgical site infections were more commonly found in certain demographics, such as patients under the age of 65 (26.75 vs. 14.73%) and in males (20.83 vs. 14.15%). Multivariate regression analysis further highlighted that certain comorbidities increased odds for infections within 90-days following ORIF for distal radius fractures and those included: morbid obesity (OR: 2.06, p < 0.0001), depression (OR: 1.92, p = 0.0002), and pathologic weight loss (OR: 1.49, p = 0.001).

CONCLUSION

The study found statistically significant dif- ferences between patients who developed and did not develop infection. These findings may help orthopedic surgeons to educate certain high-risk patients of the potential complica- tions that may occur following surgery.