Unplanned Postoperative Emergency Department Visits After Upper Extremity Fracture Surgery

Area of Science:

• Orthopedic Surgery
• Health Services Research

Background:

• Postoperative emergency department (ED) visits after upper extremity fracture surgery are a concern.
• Understanding risk factors for these visits is crucial for improving patient outcomes and resource allocation.

Purpose of the Study:

• To determine if outpatient upper extremity fracture surgery is associated with increased postoperative ED visits.
• To identify patient- and procedure-related risk factors for these ED visits.

Main Methods:

• Retrospective cohort study including adult patients undergoing upper extremity fracture surgery between 2015 and 2021.
• Multivariable logistic regression analysis was used to identify factors associated with 30- and 90-day postoperative ED visits.
• Investigated risk factors included surgical setting, tobacco use, comorbidities, race, and fracture location.

Main Results:

• Outpatient surgery was associated with a higher rate of 30-day ED visits (2.8% vs. 3.4% for inpatient).
• Key risk factors for 30-day ED visits included outpatient surgery, tobacco use, higher comorbidity scores, non-White race, and specific fracture locations (elbow, hand).
• Pain was the most common reason for ED visits (20%).

Conclusions:

• Outpatient upper extremity fracture surgery is linked to an increased rate of 30-day postoperative ED visits.
• Tobacco use, increased comorbidities, and non-White race are significant risk factors for frequent ED presentations post-surgery.