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Independent Risk Factors for Impaired Early Outcome after Isolated Ankle Fracture - A Multivariate Analysis and
Alexander Kaltenborn1,2, Michael Bullok1, Christoph Schulze1,3
1Department for Trauma Surgery, Orthopaedic, Plastic, Reconstructive and Hand Surgery, Armed Forces Hospital Westerstede.
Zeitschrift Fur Orthopadie Und Unfallchirurgie
|August 28, 2020
Summary
Ankle fracture surgery outcomes can be predicted using preoperative lab results and patient comorbidities. Prognostic models help identify high-risk patients for prolonged hospital stays and complications, improving surgical planning.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Medical Statistics
Background:
- Ankle fractures are increasingly common surgical indications in orthopedics.
- Predicting outcomes is crucial for patient management and resource allocation.
Purpose of the Study:
- Identify independent risk factors for prolonged hospital stay (LOS) after ankle fracture surgery.
- Develop prognostic models to predict prolonged LOS and postoperative complications.
- Assess the clinical validity and applicability of these predictive models.
Main Methods:
- Retrospective analysis of 154 isolated, surgically treated ankle fractures.
- Multivariate logistic regression to identify risk factors.
- Receiver Operating Characteristic (ROC) curve analysis for model validation.
- Internal validation using bootstrapping.
Main Results:
- Independent predictors for prolonged LOS include leukocytosis, elevated CRP, and bi- or trimalleolar fracture types. Immediate surgery was beneficial.
- Diabetes mellitus and elevated ASA score were significantly associated with postoperative complications.
- Prognostic models demonstrated good clinical validity for predicting prolonged LOS (AUROC: 0.736) and complications (AUROC: 0.724).
Conclusions:
- Preoperative laboratory workup is essential for predicting ankle fracture surgery outcomes.
- Patient comorbidities significantly influence prognosis.
- Validated prognostic models enable reliable preoperative risk stratification.
