Semran B Thamer, Aaron W Lam, Ivan J Golub, Matthew L Magruder, Rushabh M Vakharia, Amiethab A Aiyer, Amr A Abdelgawad
{"title":"双踝踝关节骨折切开复位内固定后的睡眠呼吸暂停和术后医疗并发症及医疗费用。","authors":"Semran B Thamer, Aaron W Lam, Ivan J Golub, Matthew L Magruder, Rushabh M Vakharia, Amiethab A Aiyer, Amr A Abdelgawad","doi":"10.1177/19386400221098629","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Sleep Apnea (SA) is a common sleep disorder that increases postoperative morbidity. There is limited research on how SA influences outcomes following operative fixation of ankle fractures. Therefore, the aim of this study was to determine whether patients who undergo surgical fixation for bimalleolar ankle fractures have higher rates of medical complications and health care expenditures.</p><p><strong>Methods: </strong>A retrospective review from January 1, 2005 to March 31, 2014 was conducted using the parts A and B Medicare Data from PearlDiver database. Patients with and without SA on the day of the primary open reduction and internal fixation (ORIF) of their bimalleolar ankle fractures were queried using the International Classification of Diseases, Ninth Revision codes. Welch's<i>t</i>-tests were used to compare costs of care. A multivariate binomial logistic regression model was used to calculate the odds ratio (OR) of adverse events. A P-value <.001 was considered statistically significant.</p><p><strong>Results: </strong>There were 20 560 patients (SA = 3150; comparison cohort = 17 410) who underwent ORIF for bimalleolar ankle fractures during the study period. Sleep apnea patients were found to have significantly higher rates and odds of 90-day medical complications (21.42% vs 7.47%, OR: 3.11, P < .0001) and 90-day costs of care ($7213.12 vs $5415.79, P < .0001).</p><p><strong>Conclusion: </strong>This research demonstrates an increased risk of postoperative medical complications and health care costs among patients with SA undergoing ORIF for bimalleolar ankle fractures.</p><p><strong>Level of evidence: </strong>Therapeutic, Level IV: Retrospective.</p>","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"1 1","pages":"552-560"},"PeriodicalIF":1.8000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sleep Apnea and Postoperative Medical Complications and Health Care Expenditures Following Open Reduction and Internal Fixation of Bimalleolar Ankle Fractures.\",\"authors\":\"Semran B Thamer, Aaron W Lam, Ivan J Golub, Matthew L Magruder, Rushabh M Vakharia, Amiethab A Aiyer, Amr A Abdelgawad\",\"doi\":\"10.1177/19386400221098629\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Sleep Apnea (SA) is a common sleep disorder that increases postoperative morbidity. 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A P-value <.001 was considered statistically significant.</p><p><strong>Results: </strong>There were 20 560 patients (SA = 3150; comparison cohort = 17 410) who underwent ORIF for bimalleolar ankle fractures during the study period. 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引用次数: 0
摘要
睡眠呼吸暂停(SA)是一种常见的睡眠障碍,可增加术后发病率。关于SA如何影响踝关节骨折手术固定后预后的研究有限。因此,本研究的目的是确定接受手术固定治疗双踝踝关节骨折的患者是否有更高的医疗并发症发生率和医疗费用。方法回顾性分析2005年1月1日至2014年3月31日期间,使用PearlDiver数据库的A、B部分Medicare数据。采用国际疾病分类第九版代码查询双踝踝关节骨折首次切开复位内固定(ORIF)当日有无SA的患者。Welch's -test用于比较护理成本。采用多元二项logistic回归模型计算不良事件的比值比(OR)。p值<。0.001被认为具有统计学意义。结果共20 560例患者(SA = 3150;对照队列= 17410),在研究期间因双踝踝关节骨折接受ORIF治疗。睡眠呼吸暂停患者的90天医疗并发症发生率和几率(21.42% vs 7.47%, OR: 3.11, P < 0.0001)和90天护理费用(7213.12美元vs 5415.79美元,P < 0.0001)均显著较高。结论:本研究表明,双踝踝关节骨折SA患者行ORIF术后并发症风险和医疗费用增加。证据水平:治疗性,IV级:回顾性。
Sleep Apnea and Postoperative Medical Complications and Health Care Expenditures Following Open Reduction and Internal Fixation of Bimalleolar Ankle Fractures.
Introduction: Sleep Apnea (SA) is a common sleep disorder that increases postoperative morbidity. There is limited research on how SA influences outcomes following operative fixation of ankle fractures. Therefore, the aim of this study was to determine whether patients who undergo surgical fixation for bimalleolar ankle fractures have higher rates of medical complications and health care expenditures.
Methods: A retrospective review from January 1, 2005 to March 31, 2014 was conducted using the parts A and B Medicare Data from PearlDiver database. Patients with and without SA on the day of the primary open reduction and internal fixation (ORIF) of their bimalleolar ankle fractures were queried using the International Classification of Diseases, Ninth Revision codes. Welch'st-tests were used to compare costs of care. A multivariate binomial logistic regression model was used to calculate the odds ratio (OR) of adverse events. A P-value <.001 was considered statistically significant.
Results: There were 20 560 patients (SA = 3150; comparison cohort = 17 410) who underwent ORIF for bimalleolar ankle fractures during the study period. Sleep apnea patients were found to have significantly higher rates and odds of 90-day medical complications (21.42% vs 7.47%, OR: 3.11, P < .0001) and 90-day costs of care ($7213.12 vs $5415.79, P < .0001).
Conclusion: This research demonstrates an increased risk of postoperative medical complications and health care costs among patients with SA undergoing ORIF for bimalleolar ankle fractures.
Level of evidence: Therapeutic, Level IV: Retrospective.