Risk factors for nonunion of bone fracture in pediatric patients
| Autor: | Zura, Robert, Kaste, Sue C., Heffernan, Michael J., Accousti, William K., Gargiulo, Dominic, Wang, Zhe, Steen, R. Grant |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Adult Male Adolescent Databases Factual vitamin D deficiency Observational Study scaphoid fractures Cohort Studies cardiovascular disease Risk Factors Odds Ratio Humans tobacco smoking Child Retrospective Studies fracture nonunion opioid use Age Factors Infant Newborn Infant Middle Aged equipment and supplies musculoskeletal system United States surgical procedures operative Logistic Models Child Preschool Fractures Ununited Female Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Adult fracture nonunion risk is related to injury severity and surgical technique, yet nonunion is not fully explained by these risk factors alone; biological risk factors are also important. We test a hypothesis that risk factors associated with pediatric fracture nonunion are similar to adult nonunion risk factors. Inception cohort study in a large payer database of pediatric fracture patients (0–17 years) in the United States in calendar year 2011. Continuous enrollment in the database was required for 12 months, to allow time to capture a nonunion diagnosis. The final database collated demographic descriptors, treatment procedures as per Current Procedural Terminology (CPT) codes, comorbidities as per International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes, and drug prescriptions as per National Drug Code Directory (Red Book) codes. Logistic regression was used to calculate odds ratios (ORs) for variables associated with nonunion. Among 237,033 pediatric fractures in 18 bones, the nonunion rate was 0.85%. Increased nonunion risk was associated with increasing age, male gender, high body-mass index, severe fracture (e.g., open fracture, multiple fractures), and tobacco smoking (all, P |
| Databáze: | OpenAIRE |
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