Asthma and Its Impact on Pediatric Patients Undergoing Surgical Management of Tibial Shaft Fractures

Authors

Meghan Tveit, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Theodore Quan, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Denver Kraft, Orthopaedic Surgery, Georgetown University School of Medicine, Washington DC, USA.
Alisa Malyavko, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Melina Recarey, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Jordan Pizzarro, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Chelsea Nguyen, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Avilash Das, Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Pradip Ramamurti, Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, USA.
Sean Tabaie, Orthopaedic Surgery, Children's National Hospital, Washington DC, USA.

Document Type

Journal Article

Publication Date

11-1-2022

Journal

Cureus

Volume

14

Issue

11

DOI

10.7759/cureus.31369

Keywords

asthma; complications; pediatrics; tibial shaft fracture; treatment

Abstract

Introduction Tibial shaft fractures are a common presenting injury among the pediatric population. Asthma is also a common diagnosis that is frequently encountered in this population and has a significant impact on healthcare utilization, quality of life, and mortality. Given the high prevalence of these conditions and risks of peri-anesthetic respiratory complications, the purpose of this study was to evaluate an association between asthma and the incidence of 30-day postoperative complications following the surgical management of tibial shaft fractures in the pediatric population. Methods The National Surgical Quality Improvement Program-Pediatric database was used to identify pediatric patients who underwent surgical treatment for tibial shaft fractures from 2013-2019. Patients were categorized into two groups: patients with a history of asthma and patients without a history of asthma. Differences in patient demographics, comorbidities, and postoperative complications were assessed using bivariate and multivariate analyses. Results Of the 2,649 patients who underwent surgical treatment for tibial shaft fractures, 115 (4.3%) had asthma. Compared to those without asthma, patients with a history of asthma were more likely to have other medical comorbidities. After controlling for the differences in baseline characteristics between the two groups, patients with asthma had an increased risk of prolonged hospital stay (OR 5.78; 95% CI 1.67 to 20.00; p=0.006). Conclusion Pediatric patients being surgically treated for tibial shaft fractures with asthma had an increased risk of prolonged hospital stay. It is important that proper preoperative workup, perioperative care, and understanding of the implications of asthma on postoperative recovery are appreciated to reduce prolonged hospitalization lengths and minimize hospital costs associated with tibial shaft fracture surgery.

APA Citation

Tveit, Meghan; Quan, Theodore; Kraft, Denver; Malyavko, Alisa; Recarey, Melina; Pizzarro, Jordan; Nguyen, Chelsea; Das, Avilash; Ramamurti, Pradip; and Tabaie, Sean, "Asthma and Its Impact on Pediatric Patients Undergoing Surgical Management of Tibial Shaft Fractures" (2022). GW Authored Works. Paper 1947.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1947

Department

Orthopaedic Surgery