Geriatric patients with ankle fracture show lower 1-year morbidity vs peers with other diagnoses
Geriatric patients with ankle fractures experienced lower 1-year morbidity compared with peers who sustained hip fractures or had an alternative admitting diagnosis, according to researchers of this study, even after they accounted for both age and comorbidity.
Using the 2008 Medicare Part A database to identify patients aged 65 years or older, researchers found 19,648 patients who were diagnosed with an ankle fracture; 193,980 patients with hip fracture; and 5,801,831 patients with a diagnosis other than hip or ankle fracture. Researchers examined 1-year mortality rates using a multivariate analysis that factored for both patient age and pre-existing comorbidities as the primary outcome measure. Additional morbidity, as reflected by length of stay, discharge disposition, readmissions and medical complications, was the secondary outcome measure.
Results showed 1-year mortality of 11.9% after ankle fracture, 28.2% after hip fracture and 21.5% after any other admission diagnosis. Researchers found mean length of stay and mean discharge rate to a nursing home were significantly lower among patients with ankle fracture vs. patients with hip fractures. Although 30-day readmission rates were clinically similar between the ankle fracture cohort and the hip fracture cohort, these rates were significantly different with rates of 13.3% vs. 15%, respectively.
Deep venous thrombosis rates were equivalent between the ankle fracture and hip fracture cohorts, but researchers found the rate of pulmonary embolism was higher in the hip fracture cohort and the rate of surgical site infection was significantly higher in the ankle fracture cohort. According to study results, the hip fracture cohort had a significantly higher 90-day complication rate for all other outcomes. – by Casey Tingle
Disclosures: Hsu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.