Thirty-Day Morbidity and Mortality in Patients With COPD Following Open Reduction and Internal Fixation for Rotational Ankle Fractures

Authors

Puneet Gupta, Department of Orthopedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Theodore Quan, Department of Orthopedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: teddyquan@gwu.edu.
Magid G. Abdo, Burrell College of Osteopathic Medicine, Las Cruces, NM.
Joseph E. Manzi, Weill Cornell Medical College, New York, NY.
Brock Knapp, Department of Orthopedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.
Gene Shaffer, Department of Orthopedic Surgery, Einstein Healthcare Network, Philadelphia, PA.

Document Type

Journal Article

Publication Date

4-7-2022

Journal

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons

DOI

10.1053/j.jfas.2022.03.015

Keywords

NSQIP; complications; orthopedics; surgery

Abstract

Prior orthopedic literature has found patients with chronic obstructive pulmonary disease (COPD) to be at an increased risk for postoperative morbidity and mortality. Thus, the purpose of this study is to identify whether there are any differences in risk for 30-day morbidity or mortality following ORIF for ankle fractures between adult patients with COPD and without COPD. Patients undergoing operative treatment for ankle fracture were identified in the National Surgical Quality Improvement Program database from 2006 to 2018. Patients were divided into 2 cohorts: non-COPD and COPD patients. In this analysis, demographics data, medical comorbidities, and thirty-day postoperative outcomes were analyzed between the 2 cohorts. Bivariate and multivariate analyses were performed. Of 10,346 total patients who underwent operative treatment for ankle fracture, 9986 patients (96.5%) did not have a history of COPD whereas 360 (3.5%) had COPD. Following adjustment to control for demographic and comorbidity data, relative to patients without COPD, those with COPD had an increased risk of pneumonia (odds ratio [OR] 4.601; p = .001), unplanned intubation (OR 3.085; p = .043), and hospital readmission (OR 1.828; p = .020). Patients with COPD did not have a statistically significant difference with regards to mortality (OR 2.729; p = .080). Adult patients with COPD are at an increased risk for pneumonia, unplanned intubation, and hospital readmission within 30 days following ORIF of ankle fractures compared to patients without COPD. Despite these risks, this is a relatively safe procedure for these patients and the presence of COPD alone should not serve as a barrier to surgery.

APA Citation

Gupta, Puneet; Quan, Theodore; Abdo, Magid G.; Manzi, Joseph E.; Knapp, Brock; and Shaffer, Gene, "Thirty-Day Morbidity and Mortality in Patients With COPD Following Open Reduction and Internal Fixation for Rotational Ankle Fractures" (2022). GW Authored Works. Paper 818.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/818

Department

School of Medicine and Health Sciences Resident Works