American Association for Hand Surgery
AAHS Home AAHS Home Past & Future Meetings Past & Future Meetings

Back to 2024 Abstracts

Preoperative Anemia as a Risk Factor for Postoperative Complications Following Open Reduction Internal Fixation of Distal Radius Fractures
Alexander Garcia, B.S.1, Kenny Ling, M.D.2, David E. Komatsu, Ph.D.2 and Edward D. Wang, M.D.2, (1)Stony Brook University Hospital, Stony Brook, NY, (2)Stony Brook University, Stony Brook, NY

Background: The incidence of distal radius fractures (DRF) in the United States is over 640,000 cases per year and is projected to increase. The overall prevalence of anemia in the United States increased from 5.71% in 2005 to 6.86% in 2018. Therefore, preoperative anemia may be an important risk factor to consider prior to surgical fixation of a distal radius fracture. The purpose of this study was to investigate preoperative anemia and its association with short-term complications following surgical treatment of distal radius fractures.
Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all patients who underwent open reduction internal fixation (ORIF) of DRF between 2015 and 2020. The initial pool of patients was divided into cohorts based on preoperative hematocrit. Multivariate logistic regression, adjusted for all significantly associated patient demographics and comorbidities, was used to identify associations between preoperative anemia and postoperative complications following ORIF of DRF.
Results: A total of 22,923 patients who underwent ORIF of DRF were identified in NSQIP from 2015 to 2020. Of the 12,068 patients remaining after exclusion criteria, 9,616 (79.7%) patients were included in the normal cohort, 2,238 (18.5%) patients were included in the mild anemia cohort, and 214 (1.8%) patients were included in the severe anemia cohort. Compared to the reference cohort, patients with any anemia were independently associated with higher rates of reintubation (OR 6.51, 95% CI 1.29-32.80; p = 0.023), blood transfusion (OR 11.83, 95% CI 3.95-35.45; p < 0.001), septic shock (OR 10.76, 95% CI 1.19-97.02; p = 0.034), readmission (OR 2.10, 95% CI 1.60-2.76, p < 0.001), non-home discharge (OR 2.22, 95% CI 1.84-2.68; p < 0.001), and mortality (OR 2.70, 1.03-7.07; p = 0.043).
Conclusion: Preoperative anemia, both mild and severe, were clinically significant predictors for postoperative complications within 30-days following ORIF of DRF. Severe anemia was associated with higher rates of blood transfusion, non-home discharge, and mortality compared to mild anemia.

aahs anemia table.jpg
Back to 2024 Abstracts