The Impact of Metabolic Syndrome on 30-Day Outcomes in Geriatric Distal Femur Fracture Surgeries

Distal femur fractures are a rising cause of morbidity among the US aging population. Due to the urgent nature of orthopaedic trauma management, preoperative optimization is often limited. Metabolic syndrome (MetS), defined by abdominal obesity, hypertriglyceridemia, dyslipidemia, hyperglycemia, and hypertension, has been associated with increased risk of postoperative complications among many surgical subspecialties. The purpose of the study was to investigate the impact of MetS on postoperative outcomes of patients with distal femur fractures.

The ACS-NSQIP database was queried for patients with distal femur fracture between 2015-2021. Patients were matched for demographics, comorbidities, and pre- and intraoperative variables using Pearson-Chi square tests. Postoperative complications were compared between groups using univariate and multivariable logistic regression analyses..

516 (14.2%) of distal femur fracture patients had a diagnosis of MetS. MetS was significantly associated with higher odds of acute renal failure (OR 2.72 [95% CI 1.02-6.90]; p = 0.038), cardiac arrest (OR 3.13 [95% CI 1.28 - 7.27]; p = 0.009), and non-home discharge (OR 1.36 [95% CI 1.06 -1.76]; p=0.018) (Table 1). There was no statistically significant difference in length of stay, surgical site infection, myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism, 30-day mortality, or reoperation rate between MetS and non-MetS group.

When compared to distal femur fracture patients without MetS, MetS patients were likely to be age > 70, on dialysis, with a history of congestive heart failure, and have bleeding disorders. Further, MetS patients had higher odds of adverse 30-day outcomes and non-home discharge. Level of Evidence: III.