■肱骨近端骨折(PHFs)切开复位内固定(ORIF)后住院时间延长与患者发病率和医疗费用增加有关。这项研究的主要目的是确定PHFORIF后延长住院时间的危险因素。
■从美国外科医生学会国家外科质量改善计划(ACSNSQIP)数据库查询2015年至2021年间接受PHFORIF的所有患者。患者人口统计学,合并症条件,收集术后30天内的并发症。延长住院时间(eLOS)定义为从手术到出院≥3天。多变量逻辑回归用于确定ORIF后eLOS的预测因子。
■与eLOS显著相关的患者的特征包括年龄≥75岁(p<.001),男性(p<0.001),体重指数(BMI)<18.5(P=.001),美国麻醉医师协会(ASA)分类≥3(P<.001),依赖功能状态(P<.001),非胰岛素依赖型糖尿病(P=.037),胰岛素依赖型糖尿病(P<0.001),慢性阻塞性肺疾病(P<0.001),充血性心力衰竭(CHF)(P<.001),高血压(P<0.001),透析(P<.013),播散性癌症(P<0.001),长期使用类固醇(P=0.004),出血性障碍(P<.001)。eLOS的独立预测因素是年龄≥75岁(OR=2.69;P<.001),BMI<18.5(OR=1.70;P=0.016),ASA≥3(OR=2.70;P<.001),依赖功能状态(OR=2.30;P<.001),CHF(OR=3.57;P<.001),播散性癌症(OR=7.62;P<.001),出血性障碍(OR=2.68;P<.001)。
■年龄≥75,BMI<18.5,ASA≥3,功能依赖,CHF,播散性癌症,出血性疾病与eLOS独立相关。
■在PHF的ORIF之前评估特定患者因素可以帮助管理围手术期风险并减少与eLOS相关的费用。
■预后III.
UNASSIGNED: An extended length of stay following open reduction and internal fixation (ORIF) for proximal humerus fractures (PHFs) is associated with increased patient morbidity and health care costs. The primary purpose of this study was to identify risk factors for an extended length of stay following ORIF for PHF.
UNASSIGNED: All patients who underwent ORIF for PHF between 2015 and 2021 were queried from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Patient demographics, comorbid conditions, and postoperative complications within 30 days of procedure were collected. Extended length of stay (eLOS) was defined by ≥ 3 days from operation to discharge. Multivariate logistic regression was employed to identify predictors of eLOS following ORIF.
UNASSIGNED: Characteristics of patients significantly associated with eLOS included age ≥ 75 years (p < .001), male gender (p < 0.001), body mass index (BMI) < 18.5 (P = .001), American Society of Anesthesiologists (ASA) classification ≥ 3 (P < .001), dependent functional status (P < .001), noninsulin-dependent diabetes (P = .037), insulin-dependent diabetes (P < .001), chronic obstructive pulmonary disease (P < .001), congestive heart failure (CHF) (P < .001), hypertension (P < 0.001), dialysis (P < .013), disseminated cancer (P < 0.001), chronic steroid use (P = .004), and bleeding disorder (P < .001). Independent predictors of eLOS were age ≥ 75 years (OR = 2.69; P < .001), BMI < 18.5 (OR = 1.70; P = .016), ASA ≥ 3 (OR = 2.70; P < .001), dependent functional status (OR = 2.30; P < .001), CHF (OR = 3.57; P < .001), disseminated cancer (OR = 7.62; P < .001), and bleeding disorder (OR = 2.68; P < .001).
UNASSIGNED: Age ≥ 75, BMI < 18.5, ASA ≥ 3, functional dependence, CHF, disseminated cancer, and bleeding disorder were independently associated with eLOS.
UNASSIGNED: Assessing specific patient factors prior to ORIF for PHF can assist in managing perioperative risks and decreasing expenses related to eLOS.
UNASSIGNED: Prognosis III.