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The Effect of Socioeconomic Status on Narcotic Consumption, Wound Complications, and Reoperations After Soft Tissue Upper Extremity Surgery
Arman Tabarestani, BS
University of Florida College of Medicine, Gainesville, FL
Introduction:The area deprivation index (ADI) is an outcome metric that quantifies socioeconomic status by stratifying neighborhoods based on zip code to help implement health policy. In this study, we investigated the effect of national ADI rank on narcotic consumption, wound complications, and reoperations after upper extremity surgery.
Methods:We conducted a retrospective review of adult patients undergoing routine upper-extremity soft tissue surgery at a single institution between 2013 and 2022. Patients were included if they underwent routine upper extremity surgeries (Table 1). Patients were excluded for having concomitant lacerations, penetrating injuries, or open fractures. Multivariable logistic regression was performed to determine whether national ADI is associated with narcotic consumption, the incidence of wound complications, and readmission after routine hand surgery procedures independent of covariates.
Results:We included 1,389 patients. The mean age was 55.1 years and 64.6% were female (Table 2). Average national ADI rank was 65.6. Wound complications occurred in 2.9% of patients (n=40) and reoperations occurred in 2.5% of patients (n=35). Multivariable regression determined that national ADI rank was not associated with a difference in narcotic consumption (p=0.141), wound complications (p=0.599), or reoperation rates (p=0.141) (Table 3). In contrast, body mass index (BMI) and corticosteroid use were associated with increased wound complications (p=0.047 and p=0.003 respectively).
Conclusions:National ADI rank was not associated with a significant difference in narcotic consumption, wound complications, or reoperation rates while BMI and corticosteroid use were associated with increased wound complications.
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