Alexander Dobek1, Theodore Quan2,3, Joseph E Manzi4, Pradip Ramamurti5, Sean Tabaie6. 1. Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. 2. Weill Cornell Medical College, New York City, NY, USA. teddyquan@gwu.edu. 3. George Washington University School of Medicine and Health Sciences, 2300 Eye St NW, Washington DC, 20037, USA. teddyquan@gwu.edu. 4. Weill Cornell Medical College, New York City, NY, USA. 5. Department of Orthopaedic Surgery, University of Virginia Medical Center, Charlottesville, VA, USA. 6. Department of Orthopaedic Surgery, Children's National Health System, Washington, DC, USA.
Abstract
PURPOSE: Femoral shaft fractures are common in the pediatric population, accounting for over 20% of inpatient pediatric fractures. Patients with developmental delays are a population group whose medical care and recovery come with a unique set of considerations and challenges. The purpose of this study was to evaluate the impact of developmental delay on outcomes following open treatment of femoral shaft fractures in the pediatric population. METHODS: Pediatric patients undergoing open treatment of femoral shaft fracture from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were divided into two groups: patients with developmental delay and patients without developmental delay. Patient demographics, comorbidities, and various postoperative outcomes were compared between the two groups using bivariate and multivariate analyses. RESULTS: Of the 5896 pediatric patients who underwent open treatment of femoral shaft fracture, 5479 patients (92.9%) did not have developmental delay whereas 417 (7.1%) had developmental delay. Patients with developmental delay were more likely to have other medical comorbidities. Following adjustment on multivariable regression analysis to control for the baseline differences between the two groups, patients with developmental delay had an increased risk of readmission to the hospital (OR 4.762; p = 0.014). CONCLUSION: Developmental delay in the pediatric population was found to be an independent risk factor for hospital readmission following open treatment of femoral shaft fractures. Taking these patients into special consideration when evaluating the optimal treatment plan can be beneficial to reduce the risks of readmission, which can decrease costs for both the patient and the hospital.
PURPOSE: Femoral shaft fractures are common in the pediatric population, accounting for over 20% of inpatient pediatric fractures. Patients with developmental delays are a population group whose medical care and recovery come with a unique set of considerations and challenges. The purpose of this study was to evaluate the impact of developmental delay on outcomes following open treatment of femoral shaft fractures in the pediatric population. METHODS: Pediatric patients undergoing open treatment of femoral shaft fracture from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were divided into two groups: patients with developmental delay and patients without developmental delay. Patient demographics, comorbidities, and various postoperative outcomes were compared between the two groups using bivariate and multivariate analyses. RESULTS: Of the 5896 pediatric patients who underwent open treatment of femoral shaft fracture, 5479 patients (92.9%) did not have developmental delay whereas 417 (7.1%) had developmental delay. Patients with developmental delay were more likely to have other medical comorbidities. Following adjustment on multivariable regression analysis to control for the baseline differences between the two groups, patients with developmental delay had an increased risk of readmission to the hospital (OR 4.762; p = 0.014). CONCLUSION: Developmental delay in the pediatric population was found to be an independent risk factor for hospital readmission following open treatment of femoral shaft fractures. Taking these patients into special consideration when evaluating the optimal treatment plan can be beneficial to reduce the risks of readmission, which can decrease costs for both the patient and the hospital.
Authors: Mehul V Raval; Peter W Dillon; Jennifer L Bruny; Clifford Y Ko; Bruce L Hall; R Lawrence Moss; Keith T Oldham; Karen E Richards; Charles D Vinocur; Moritz M Ziegler Journal: J Pediatr Surg Date: 2011-01 Impact factor: 2.545
Authors: Sameer M Naranje; Matthew G Stewart; Derek M Kelly; Tamekia L Jones; David D Spence; William C Warner; James H Beaty; Jeffrey R Sawyer Journal: J Pediatr Orthop Date: 2016 Oct-Nov Impact factor: 2.324