Thus, the patient population was separated into 2 groups: those readmitted within 30 days after surgery and those not readmitted within 30 days after surgery. Readmission after surgery is reported as a discrete data element in the NSQIP database. The NSQIP database and the hospitals participating in the NSQIP database are the source of the data used herein they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. The NSQIP database meets both of these criteria, and studies using this database have been deemed exempt from review by the Institutional Review Board at our institution. This part of the federal regulations covers research involving the collection or study of existing data, documents, and records if these sources are publicly available or if the information is recorded by the investigator in such a manner that subjects cannot be identified. This research is exempt from review under the parts of the federal regulation 45 Code of Federal Regulations 46.101(b)(4). A total of 11,124 patients were analyzed in this study. Patients with missing sex, height, weight, the American Society of Anesthesiologists (ASAs) classification, or functional status data were excluded, and this comprised less than 1% of the study population. 19, 20Īll adult patients aged 18 years and older undergoing DRF ORIF were identified using the following Current Procedural Terminology (CPT) codes: 25607 (open reduction and internal fixation for extra-articular fracture), 25608 (intra-articular fracture), and 25609 (comminuted fracture). 18 In recent years, the NSQIP has become widely accepted as a reliable instrument for analyzing adverse event (AE) data associated with orthopaedic surgical procedures. This database is a clinical registry which collects over 150 perioperative and demographic variables from over 650 hospitals in the United States. These findings will also be useful for readmission benchmarking, risk stratification, and risk adjustment.Ī retrospective analysis was performed using data from the 2011 to 2016 NSQIP database. Our findings could be useful for patient counseling, medical clearance, and postoperative management. To accomplish this goal, we used the large sample size, high data quality, and nationally representative cohort available in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. This study was thus performed to investigate the national rate of readmission after ORIF of DRF and to assess predictive factors, reasons for readmission, and timing of readmissions. 11, 15, 16, 17 This makes it difficult to interpret the results, with some studies having over 300 procedural codes aggregated in a single analysis. Other studies have used state databases, which have the limitations inherent to administrative databases, 12, 13, 14 or have grouped hand and forearm diagnoses. 8, 9, 10 Single institution studies are limited by a small sample size and limited generalizability, Goodman et al 11 studied 314 ORIFs with one unplanned revision surgery within 30 days of the procedure. Previous studies that investigated surgical outcomes after DRF ORIF have not focused on readmissions. 4, 5, 6 For example, hospitals can now be penalized up to 3% of their reimbursements for failing to meet the established readmission benchmarks. 3 In fact, national programs such as the Hospital Readmissions Reduction Program have been developed under the new Patient Protection and Affordable Care Act to help incentivize system-wide changes that address metrics such as readmission. One such measure is the rate of postoperative readmissions. 1 Open reduction and internal fixation (ORIF) of these injuries is increasing in frequency, 2 and measures of quality are under increasing scrutiny. Distal radius fracture (DRF) is one of the most common fractures in adults accounting for up to 18% of all fractures in the elderly age group, and recent data suggest a trend toward increasing incidence.
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