gms | German Medical Science

Objectives/Interrogation: Metabolic syndrome is increasing in prevalence in the United States and around the world, producing an enlarging burden on healthcare systems. Previously defined by a simplified, 3-comorbidity index consisting of hypertension, diabetes, and obesity (BMI>30), metabolic syndrome has been shown to be predictive of adverse outcomes after a variety of orthopaedic surgeries. To date, there is no analysis of a nationwide database assessing the impact of metabolic syndrome on outcomes after operative treatment of forearm fractures.

Methods: The 2005-2014 National Quality Improvement Program Database (NSQIP) was retrospectively queried for patients undergoing operative fixation of radial and/or ulnar fractures based on 31 current procedural terminology (CPT) codes. Open and closed treatments were included. Primary outcome was unplanned readmission after surgery. Univariate analysis was conducted on comorbidities with Pearson's Chi Square. Binary logistic regression was performed with significant comorbidities and demographics.

Results and Conclusions: A total of 21,082 patients were included in our analysis. Approximately 30% of patients were of age 65 or older, and the majority were Caucasian. Metabolic syndrome was present in 616 (2.9%) of patients, and unplanned reoperation occurred in 303 (1.4%) of cases. Mortality rate was 0.4% (86 patients) (Table 1 [Tab. 1], Table 2 [Tab. 2], Table 3 [Tab. 3]).

Patients in our cohort with metabolic syndrome undergoing operative fixation of radial or ulnar fractures have 2.95 increased odds of having an unplanned reoperation. Metabolic syndrome is an independent risk factor for adverse outcomes after surgery and presents an increasing burden on healthcare systems worldwide.