Emergency Department Visits Following Supracondylar Humerus Fractures

Pediatric supracondylar humerus fractures are common and the most frequent pediatric fracture to require surgical intervention. After initial management, emergency department (ED) visits subsequent to this injury/surgery are not well characterized, but are of clinical interest.

Pediatric patients (age >1 ​​​​​​y old and <13 y old) with supracondylar humerus fractures were identified from the 2010 to 2021 PearlDiver M157 administrative database. These patients were stratified based on whether they visited the emergency department at least once within 90 days after their initial injury diagnosis/management. The timing of visits and reasons were determined, and predictive factors were assessed with multivariate logistical regression.

A total of 92,994 fractures were identified for which post-injury/post-operative ED visits were noted for 10,325 patients (11.1%). Nearly half of all ED visits occurred within the 2 weeks immediately after the fracture (46.1%), of which 54.7% of visits were not directly related to the elbow. On multivariate analysis, patients who utilized the ED after initial management of pediatric supracondylar humerus fracture were of greater odds ratio (OR) in decreasing order to have: had a history of ED visits before their initial injury (OR: 2.69), be diabetic (OR: 1.81), had surgical intervention for their fracture (OR:1.58), be obese (OR: 1.57), have asthma (OR:1.55), have Medicaid insurance (OR: 1.29), and be younger (OR: 1.11 per year decrease) ( P <0.001 for all).

In the 90 days after pediatric supracondylar humerus fracture, more than 1 in 10 patients visited the ED. This data highlight the need for close following of such patients after their injury/surgery and suggests risk factors for which patients such quality improvement measures should be focused.

III.