The association between smoking status and 30-day readmission incidence after ORIF for radius and/or ulna fractures
Abstract
Introduction and Objective. Smoking has been shown to be associated with increased risk of complications after surgical intervention, possibly due to the different components found in cigarettes. Many studies have analyzed different complications, such as wound dehiscence, by smoking status but have not measured readmissions among those with radius or ulna fractures. This study aims to evaluate whether smoking status affects 30-day readmission incidence among adult patients who undergo ORIF of the radius or ulna. Methods. Using the 2016 ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database, a retrospective cohort study was conducted. The study cohort included those who met the database codebook criteria for fracture of the radius or ulna with open reduction and internal fixation. Demographics of each patient as well as comorbidities were evaluated. These demographics included age, sex, race, ASA classification, BMI and co-morbid conditions such as diabetes mellitus, hypertension, chronic kidney disease and others. The association between smoking status and 30-day readmission was evaluated by statistical analyses including chi square tests for dichotomous variables and logistic regression models for multivariable analysis. Results. After applying the inclusion criteria, 4,815 patients were analyzed of which 983 (20.4%) were current smokers. While the point estimate demonstrated smokers as 1.51 times more likely to be readmitted following ORIF for ulna and/or radius fractures compared to non-smokers, this finding was not statistically significant (CI 95%: 0.84-2.71). Other important incidental findings included overweight patients (BMI 25-29.9) being 51% less likely to have a readmission compared to patients with normal BMI (18.5-24.9) (CI 95%: 0.23-1.01) and patients with bleeding disorders being 6.05 times more likely to have a readmission compared to patients without bleeding disorders (CI 95%: 2.85-12.84). Conclusions-Implications. Smoking status was not associated with readmission incidence for patients undergoing ORIF for distal forearm fractures. Future studies are needed to evaluate possible tobacco dose-dependent responses to readmission incidence and should utilize an expanded dataset.
Keywords
unplanned readmission, bone fracture, smoking
Presentation Type
Poster Presentation
The association between smoking status and 30-day readmission incidence after ORIF for radius and/or ulna fractures
Introduction and Objective. Smoking has been shown to be associated with increased risk of complications after surgical intervention, possibly due to the different components found in cigarettes. Many studies have analyzed different complications, such as wound dehiscence, by smoking status but have not measured readmissions among those with radius or ulna fractures. This study aims to evaluate whether smoking status affects 30-day readmission incidence among adult patients who undergo ORIF of the radius or ulna. Methods. Using the 2016 ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database, a retrospective cohort study was conducted. The study cohort included those who met the database codebook criteria for fracture of the radius or ulna with open reduction and internal fixation. Demographics of each patient as well as comorbidities were evaluated. These demographics included age, sex, race, ASA classification, BMI and co-morbid conditions such as diabetes mellitus, hypertension, chronic kidney disease and others. The association between smoking status and 30-day readmission was evaluated by statistical analyses including chi square tests for dichotomous variables and logistic regression models for multivariable analysis. Results. After applying the inclusion criteria, 4,815 patients were analyzed of which 983 (20.4%) were current smokers. While the point estimate demonstrated smokers as 1.51 times more likely to be readmitted following ORIF for ulna and/or radius fractures compared to non-smokers, this finding was not statistically significant (CI 95%: 0.84-2.71). Other important incidental findings included overweight patients (BMI 25-29.9) being 51% less likely to have a readmission compared to patients with normal BMI (18.5-24.9) (CI 95%: 0.23-1.01) and patients with bleeding disorders being 6.05 times more likely to have a readmission compared to patients without bleeding disorders (CI 95%: 2.85-12.84). Conclusions-Implications. Smoking status was not associated with readmission incidence for patients undergoing ORIF for distal forearm fractures. Future studies are needed to evaluate possible tobacco dose-dependent responses to readmission incidence and should utilize an expanded dataset.