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The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures

The aim of this study was to characterize the case volume dependence of both facilities and surgeons on morbidity and mortality after femoral shaft fracture (FSF) fixation. METHODS: Adults who had an open or closed FSF between 2011 and 2015 were identified in the New York Statewide Planning and Rese...

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Autores principales: Testa, Edward J., Brodeur, Peter G., Lama, Christopher J., Hartnett, Davis A., Painter, David, Gil, Joseph A., Cruz, Aristides I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162792/
https://www.ncbi.nlm.nih.gov/pubmed/37141166
http://dx.doi.org/10.5435/JAAOSGlobal-D-22-00242
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author Testa, Edward J.
Brodeur, Peter G.
Lama, Christopher J.
Hartnett, Davis A.
Painter, David
Gil, Joseph A.
Cruz, Aristides I.
author_facet Testa, Edward J.
Brodeur, Peter G.
Lama, Christopher J.
Hartnett, Davis A.
Painter, David
Gil, Joseph A.
Cruz, Aristides I.
author_sort Testa, Edward J.
collection PubMed
description The aim of this study was to characterize the case volume dependence of both facilities and surgeons on morbidity and mortality after femoral shaft fracture (FSF) fixation. METHODS: Adults who had an open or closed FSF between 2011 and 2015 were identified in the New York Statewide Planning and Research Cooperative System database. Claims were identified by International Classification of Disease-9, Clinical Modification diagnostic codes for a closed or open FSF and International Classification of Disease-9, Clinical Modification procedure codes for FSF fixation. Readmission, in-hospital mortality, and other adverse events were compared across surgeon and facility volumes using multivariable Cox proportional hazards regression, controlling for patient demographic and clinical factors. Surgeon and facility volumes were compared between the lowest and highest 20% to represent low-volume and high-volume surgeons/facilities. RESULTS: Of 4,613 FSF patients identified, 2,824 patients were treated at a high or low-volume facility or by a high or low-volume surgeon. Most of the examined complications including readmission and in-hospital mortality showed no statistically significant differences. Low-volume facilities had a higher 1-month rate of pneumonia. Low-volume surgeons had a lower 3-month rate of pulmonary embolism. CONCLUSION: There is minimal difference in outcomes in relation to facility or surgeon case volume for FSF fixation. As a staple of orthopaedic trauma care, FSF fixation is a procedure that may not require specialized orthopaedic traumatologists at high-volume facilities.
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spelling pubmed-101627922023-05-06 The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures Testa, Edward J. Brodeur, Peter G. Lama, Christopher J. Hartnett, Davis A. Painter, David Gil, Joseph A. Cruz, Aristides I. J Am Acad Orthop Surg Glob Res Rev Research Article The aim of this study was to characterize the case volume dependence of both facilities and surgeons on morbidity and mortality after femoral shaft fracture (FSF) fixation. METHODS: Adults who had an open or closed FSF between 2011 and 2015 were identified in the New York Statewide Planning and Research Cooperative System database. Claims were identified by International Classification of Disease-9, Clinical Modification diagnostic codes for a closed or open FSF and International Classification of Disease-9, Clinical Modification procedure codes for FSF fixation. Readmission, in-hospital mortality, and other adverse events were compared across surgeon and facility volumes using multivariable Cox proportional hazards regression, controlling for patient demographic and clinical factors. Surgeon and facility volumes were compared between the lowest and highest 20% to represent low-volume and high-volume surgeons/facilities. RESULTS: Of 4,613 FSF patients identified, 2,824 patients were treated at a high or low-volume facility or by a high or low-volume surgeon. Most of the examined complications including readmission and in-hospital mortality showed no statistically significant differences. Low-volume facilities had a higher 1-month rate of pneumonia. Low-volume surgeons had a lower 3-month rate of pulmonary embolism. CONCLUSION: There is minimal difference in outcomes in relation to facility or surgeon case volume for FSF fixation. As a staple of orthopaedic trauma care, FSF fixation is a procedure that may not require specialized orthopaedic traumatologists at high-volume facilities. Wolters Kluwer 2023-05-03 /pmc/articles/PMC10162792/ /pubmed/37141166 http://dx.doi.org/10.5435/JAAOSGlobal-D-22-00242 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Testa, Edward J.
Brodeur, Peter G.
Lama, Christopher J.
Hartnett, Davis A.
Painter, David
Gil, Joseph A.
Cruz, Aristides I.
The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title_full The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title_fullStr The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title_full_unstemmed The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title_short The Effect of Surgeon and Hospital Volume on Morbidity and Mortality After Femoral Shaft Fractures
title_sort effect of surgeon and hospital volume on morbidity and mortality after femoral shaft fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162792/
https://www.ncbi.nlm.nih.gov/pubmed/37141166
http://dx.doi.org/10.5435/JAAOSGlobal-D-22-00242
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