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Ranking the Orthopedic Procedures With the Highest Morbidity and Mortality.

Brady S Ernst, Nicholas R Kiritsis, Phillip B Wyatt

    Orthopedics
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    This summary is machine-generated.

    Orthopedic surgery risks vary significantly, with above-knee amputations having the highest mortality and femoral shaft fracture repair showing the most adverse events. Lower extremity procedures and those in older adults carry increased risks.

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    Area of Science:

    • Orthopedic Surgery
    • Patient Safety
    • Risk Stratification

    Background:

    • Musculoskeletal conditions impact over a third of the US population, making orthopedic procedures crucial for management.
    • Invasive orthopedic interventions carry inherent risks, necessitating clear understanding of associated morbidity and mortality.
    • A global perspective on orthopedic procedure risks is needed to develop effective risk stratification tools.

    Purpose of the Study:

    • To provide a global overview of risks and complications associated with orthopedic procedures.
    • To establish an accessible risk stratification tool for patients and healthcare providers.
    • To analyze morbidity and mortality rates across various orthopedic surgical procedures.

    Main Methods:

    • Utilized Current Procedural Terminology (CPT) codes for orthopedic surgeries from the 2018-2020 American College of Surgeons National Surgical Quality Improvement Program database.
    • Assessed 30-day mortality rates and rates of any adverse event (AAE) for each identified CPT code.
    • Ranked CPT codes based on morbidity and AAE rates for descriptive analysis.

    Main Results:

    • Analyzed 698,549 patients across 94 CPT codes with morbidity and 144 CPT codes with AAE.
    • Above-knee amputation (CPT code 27590) demonstrated the highest mortality rate.
    • Open treatment of femoral shaft fracture with plate and screws (CPT code 27507) exhibited the highest rate of AAE.

    Conclusions:

    • This study is the first to compare morbidity and mortality rates across all orthopedic procedures.
    • A notable bias indicates increased risk associated with lower extremity surgeries.
    • Orthopedic procedures frequently performed in the geriatric population showed a higher risk profile.