Operative Treatment of Acetabular Fractures in the Medicare Population
| Autor: | Edmund Lau, Colin M Carroll, Steven M. Kurtz, Kevin L. Ong, Peter J. Hayes, Arthur L. Malkani, David Seligson, Craig S. Roberts |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Deep vein Medicare Fracture Fixation Internal Fractures Bone Postoperative Complications Risk Factors Prevalence medicine Animals Humans Internal fixation Orthopedics and Sports Medicine Aged Aged 80 and over business.industry Acetabulum medicine.disease Thrombosis United States Osteotomy Pulmonary embolism Surgery Survival Rate Venous thrombosis Treatment Outcome medicine.anatomical_structure Orthopedic surgery Cats Current Procedural Terminology Female Diagnosis code business |
| Zdroj: | Orthopedics. 36 |
| ISSN: | 1938-2367 0147-7447 2013-0724 |
| Popis: | Full article available online at Healio.com/Orthopedics. Search: 20130724-25 abstract The purpose of this study was to determine the incidence of and evaluate the risk for com- plications and mortality following open treatment of acetabular fractures in the Medicare population. Patients treated with open reduction and internal fixation (ORIF) for acetabu - lar fractures were identified using current procedural terminology codes in a 5% nation - al sample of Medicare records. Complications within 90 days and within 1 year were evaluated based on the presence of ICD-9-CM diagnosis codes and Current Procedural Terminology reoperation codes. A total of 1286 fractures were treated closed and 359 were treated with ORIF. Multivariate Cox regression was performed to compare complica- tion rates and risk factors. The incidence of acetabular fractures in the Medicare population has increased by 29% since 1998. Complications in the ORIF group included cardiac complications, deep venous thrombosis, infection, pulmonary embolism, refixation, and conversion to total hip arthroplasty. Risk factors for complications with ORIF included advanced age and comorbidities. Mortality in the ORIF group was 14.4% at 1 year. The incidence of reoperation with conversion to total hip arthroplasty or revision fixation fol - lowing ORIF is 10% and 15%, respectively. Further investigation is required to improve outcomes and decrease complications in this group of patients, especially cardiac, deep vein thrombosis, and infection. |
| Databáze: | OpenAIRE |
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