Adam Adler1, Matthew R Boylan2, Carl Rosenberg3, Robert Pivec1, Bhaveen H Kapadia1, Vidushan Nadarajah1, Qais Naziri1, Steven F Harwin4, Carl B Paulino1. 1. Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY. 2. Department of Orthopaedic Surgery and the Department of Epidemiology and Biostatistics, SUNY Downstate Medical Center, Brooklyn, NY. 3. Department of Epidemiology and Biostatistics, SUNY Downstate School of Public Health, Brooklyn, NY. 4. Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY.
Abstract
BACKGROUND: Open fracture is a serious orthopaedic injury that can lead to significant patient morbidity and mortality. There is limited data on the mortality risk for open compared to closed long bone fracture. METHODS: The Nationwide Inpatient Sample was used to identify all patients who were admitted with a long bone fracture in the United States between 1998 and 2010. Cox proportional hazards regression modeling was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of mortality. RESULTS: After adjusting for age, gender, race, insurance, and comorbidities, the HR of mortality was 2.89 (95% CI, 2.56-3.28; p<0.001) for open compared to closed fracture. Stratified by anatomical site, the HR of mortality for open compared to fracture was 3.43 for femur (95% CI, 2.78-4.23; p<0.001), 2.81 for tibia or fibula (95% CI, 2.17-3.64; p<0.001), 2.54 for humerus (95% CI, 1.81-3.56; p<0.001), and 1.56 for radius or ulna (95% CI, 1.10-2.23; p=0.014). CONCLUSIONS: This data suggests that open fracture carries a worse prognosis compared to closed fracture at the same anatomical site.
BACKGROUND:Open fracture is a serious orthopaedic injury that can lead to significant patient morbidity and mortality. There is limited data on the mortality risk for open compared to closed long bone fracture. METHODS: The Nationwide Inpatient Sample was used to identify all patients who were admitted with a long bone fracture in the United States between 1998 and 2010. Cox proportional hazards regression modeling was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of mortality. RESULTS: After adjusting for age, gender, race, insurance, and comorbidities, the HR of mortality was 2.89 (95% CI, 2.56-3.28; p<0.001) for open compared to closed fracture. Stratified by anatomical site, the HR of mortality for open compared to fracture was 3.43 for femur (95% CI, 2.78-4.23; p<0.001), 2.81 for tibia or fibula (95% CI, 2.17-3.64; p<0.001), 2.54 for humerus (95% CI, 1.81-3.56; p<0.001), and 1.56 for radius or ulna (95% CI, 1.10-2.23; p=0.014). CONCLUSIONS: This data suggests that open fracture carries a worse prognosis compared to closed fracture at the same anatomical site.
Authors: Filipe Coelho DA Costa; José Mateus Dos Reis; Sérgio Pereira Dos Reis; Lucas Alves Bartelega; Nathan Ferreira DE Melo; Carlos Delano Mundim Araújo Journal: Acta Ortop Bras Date: 2022-08-26 Impact factor: 0.683