Risk Factors for 30-Day Readmission and Reoperation Following Clavicle Open Reduction Internal Fixation

Introduction Clavicle open reduction internal fixation (ORIF) is an effective treatment for the surgical management of clavicle fractures. However, the literature surrounding the risk factors for readmission and reoperation following clavicle ORIF remains understudied. The purpose of this study is to investigate the specific risk factors for 30-day readmission and reoperation following clavicle ORIF. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all patients between 2015 and 2020 who underwent clavicle ORIF. Patients were divided into cohorts, both for readmission and reoperation status, after exclusion criteria. Bivariate logistic regression was used to identify patient demographics and comorbidities associated with readmission and reoperation. Multivariate logistic regression, adjusted for all significant patient demographics and comorbidities, was used to identify the risk factors independently associated with 30-day readmission and reoperation following clavicle ORIF. Results A total of 6,132 patients remained after exclusion criteria, with a readmission rate of 0.85% and a reoperation rate of 1.2%. On multivariate analysis, age 40-64 (odds ratio (OR) 2.79, 95% confidence interval (CI) 1.38-5.63; p = 0.004), age 65-74 (OR 3.07, 95% CI 1.00-9.41; p = 0.049), age ≥75 (OR 4.90, 95% CI 1.13-21.22; p = 0.033), American Society of Anesthesiologists (ASA) ≥3 (OR 2.71, 95% CI 1.26-5.37; p = 0.004), and smoking (OR 3.27, 95% CI 1.83-5.87; p < 0.001) were found to be independent risk factors for 30-day readmission. Additionally, age 40-64 years (OR 2.65, 95% CI 1.48-4.78; p = 0.001), age 65-74 (OR 3.51, 95% CI 1.44-8.57; p = 0.006), ASA ≥3 (OR 3.26, 95% CI 1.85-5.77; p < 0.001), and smoking (OR 2.84, 95% CI 1.74-4.65; p < 0.001) were found to be independent risk factors for 30-day reoperation. Conclusion Age ≥40 years, ASA ≥3, and smoking were identified as independent risk factors for 30-day readmission. Age 40-74 years, ASA ≥3, and smoking were identified as independent risk factors for 30-day reoperation. These results can guide physicians in preoperative patient counseling and management. Level of evidence Level III, retrospective cohort study.