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Surgical treatment of geriatric ankle fractures may offer lower mortality rates

September 20, 2014

CHICAGO — Geriatric patients who had operative intervention for ankle fractures showed ad lower mortality and fewer comorbidities compared to patients who underwent nonoperative treatment, according to a presenter at the International Federation of Foot & Ankle Societies Triennial Meeting, here.
Jason T. Bariteau, MD, and colleagues retrospectively culled data from the 2008 Medicare part A inpatient claims database regarding approximately 19,648 patients who had sustained ankle fractures. Variables evaluated included mortality, age, length of stay and biographical characteristics. Elixhauser and Deyo-Charlson scores were used to determine the level of comorbidities in both the operative and nonoperative patient groups. Multivariate logistic regression analysis was then used to show the protective effects of operative intervention on patient mortality.
Overall, 15,193 patients (77.33%) underwent operative intervention for ankle fractures. Mortality at the 1-year follow-up was 21.5% for nonoperative patients and 9.1% for operative patients. Mean Elixhauser and Deyo-Charlson scores were 2.5 and 1.3, respectively, for the nonoperative group and 2.2 and 1.0, respectively, for patients in the operative group. Odds ratio for death was 0.49 at 1 year follow-up for patients who had surgery.

“We are not sure if this is related to surgery in and of itself or if we treat these patients differently that they have surgery” Bariteau said. —by Christian Ingram

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Original Research

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