Malcolm Dombrowski1, Christopher D Murawski1, Youichi Yasui2,3, Antonia F Chen4, Samuel O Ewalefo1, Mitchell S Fourman1, John G Kennedy3, MaCalus V Hogan5. 1. Foot and Ankle Injury Research [F.A.I.R.] group, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Ave., Pittsburgh, PA, 15213, USA. 2. Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan. 3. Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA. 4. Department of Orthopaedic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. 5. Foot and Ankle Injury Research [F.A.I.R.] group, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Ave., Pittsburgh, PA, 15213, USA. hoganmv@upmc.edu.
Abstract
PURPOSE: To assess the effects of medical comorbidities on the incidence of surgical site infection following primary Achilles tendon repair. A secondary aim was to assess the effects of specific medical comorbidities on the cost and extent of healthcare utilization related to surgical site infection following primary Achilles tendon repair. METHODS: 24,269 patients undergoing primary Achilles tendon repair between 2005 and 2012 were examined. Current Procedural Terminology codes for primary Achilles tendon repair, and incision and drainage were used to search for and compile patient data from the United Healthcare Orthopedic and Medicare databases. Primary outcome measures regarding surgical site infection following primary Achilles tendon repair included the rate of occurrence, cost, and duration of treatment. RESULTS: Patients with one or more preexisting medical comorbidities at the time of surgery had an increased rate of surgical site infection compared to those without. Diabetes and vascular complications were associated with the highest surgical site infection rates. The rate of surgical incision and drainage was higher in patients with cardiac arrhythmias and uncomplicated hypertension. The presence of a medical comorbidity significantly increased the cost and duration of surgical site infection treatment. CONCLUSIONS: Medical comorbidities can complicate the postoperative course for patients undergoing Achilles tendon repair, which increases the cost of care and duration of treatment. A better understanding of the relationship between each medical comorbidity and surgical site infections following Achilles tendon repair may be ascertained with additional prospective studies, thus, allowing for a more accurate evaluation and stratification of surgical candidates to improve patient outcomes. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
PURPOSE: To assess the effects of medical comorbidities on the incidence of surgical site infection following primary Achilles tendon repair. A secondary aim was to assess the effects of specific medical comorbidities on the cost and extent of healthcare utilization related to surgical site infection following primary Achilles tendon repair. METHODS: 24,269 patients undergoing primary Achilles tendon repair between 2005 and 2012 were examined. Current Procedural Terminology codes for primary Achilles tendon repair, and incision and drainage were used to search for and compile patient data from the United Healthcare Orthopedic and Medicare databases. Primary outcome measures regarding surgical site infection following primary Achilles tendon repair included the rate of occurrence, cost, and duration of treatment. RESULTS:Patients with one or more preexisting medical comorbidities at the time of surgery had an increased rate of surgical site infection compared to those without. Diabetes and vascular complications were associated with the highest surgical site infection rates. The rate of surgical incision and drainage was higher in patients with cardiac arrhythmias and uncomplicated hypertension. The presence of a medical comorbidity significantly increased the cost and duration of surgical site infection treatment. CONCLUSIONS: Medical comorbidities can complicate the postoperative course for patients undergoing Achilles tendon repair, which increases the cost of care and duration of treatment. A better understanding of the relationship between each medical comorbidity and surgical site infections following Achilles tendon repair may be ascertained with additional prospective studies, thus, allowing for a more accurate evaluation and stratification of surgical candidates to improve patient outcomes. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
Entities:
Keywords:
Achilles tendon rupture; Comorbidity; Surgical site infection
Authors: Francesco Oliva; Emanuela Marsilio; Giovanni Asparago; Alessio Giai Via; Carlo Biz; Johnny Padulo; Marco Spoliti; Calogero Foti; Gabriella Oliva; Stefania Mannarini; Alessandro Alberto Rossi; Pietro Ruggieri; Nicola Maffulli Journal: J Clin Med Date: 2022-06-27 Impact factor: 4.964
Authors: Lambert T Li; Carlin Chuck; Steven L Bokshan; Ryan O'Donnell; Raymond Y Hsu; Brad D Blankenhorn; Brett D Owens Journal: Orthop J Sports Med Date: 2020-04-20
Authors: Connor R Crutchfield; Jack R Zhong; Nathan J Lee; Thomas A Fortney; Christopher S Ahmad; T Sean Lynch Journal: Arthrosc Sports Med Rehabil Date: 2022-06-13