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Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012
PURPOSE: To estimate the rate of surgical treatment of paediatric proximal humerus fractures over time utilizing a large, publicly available national database. METHODS: The Healthcare Cost and Utilization Project Kids’ Inpatient Database was evaluated between the years 2000 and 2012. Proximal humeru...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902743/ https://www.ncbi.nlm.nih.gov/pubmed/29707048 http://dx.doi.org/10.1302/1863-2548.12.170220 |
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author | Cruz Jr, A. I. Kleiner, J. E. Gil, J. A. Goodman, A. D. Daniels, A. H. Eberson, C. P. |
author_facet | Cruz Jr, A. I. Kleiner, J. E. Gil, J. A. Goodman, A. D. Daniels, A. H. Eberson, C. P. |
author_sort | Cruz Jr, A. I. |
collection | PubMed |
description | PURPOSE: To estimate the rate of surgical treatment of paediatric proximal humerus fractures over time utilizing a large, publicly available national database. METHODS: The Healthcare Cost and Utilization Project Kids’ Inpatient Database was evaluated between the years 2000 and 2012. Proximal humerus fractures were identified using International Classification of Diseases, 9(th) Revision, Clinical Modification (ICD-9 CM) diagnosis codes. ICD-9 CM procedure codes were used to identify patients who received surgical treatment. Univariable and multivariable logistic regression were used to determine variables associated with greater proportions of surgical treatment. All statistical analyses were performed utilizing SAS statistical software v.9.4. Statistical significance was set at p < 0.05. RESULTS: A total of 7520 proximal humerus fracture admissions were identified; 3247 (43.2%) were treated surgically. The percentage of patients receiving surgery increased from 39.3% in 2000 to 46.4% in 2012 (p < 0.001). After adjustment for potential confounders, increased age, increased ICD-9 derived injury severity scores (ICISS) and more recent year were associated with an increased proportion of patients receiving surgical treatment (p < 0.001). Medicaid payer status (p < 0.001) and admission to a children’s hospital (p = 0.045) were associated with a lower proportion of surgical treatment. CONCLUSION: The rate of operative treatment of paediatric proximal humerus fractures increased over time between 2000 and 2012. Increased surgical rates were independently associated with older age, increased ICISS, treatment at a non-children’s hospital and non-Medicaid insurance status. Further study is needed to provide evidence to support improved outcomes after operative treatment of paediatric proximal humerus fractures. LEVEL OF EVIDENCE IV: |
format | Online Article Text |
id | pubmed-5902743 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-59027432018-04-27 Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 Cruz Jr, A. I. Kleiner, J. E. Gil, J. A. Goodman, A. D. Daniels, A. H. Eberson, C. P. J Child Orthop Original Clinical Article PURPOSE: To estimate the rate of surgical treatment of paediatric proximal humerus fractures over time utilizing a large, publicly available national database. METHODS: The Healthcare Cost and Utilization Project Kids’ Inpatient Database was evaluated between the years 2000 and 2012. Proximal humerus fractures were identified using International Classification of Diseases, 9(th) Revision, Clinical Modification (ICD-9 CM) diagnosis codes. ICD-9 CM procedure codes were used to identify patients who received surgical treatment. Univariable and multivariable logistic regression were used to determine variables associated with greater proportions of surgical treatment. All statistical analyses were performed utilizing SAS statistical software v.9.4. Statistical significance was set at p < 0.05. RESULTS: A total of 7520 proximal humerus fracture admissions were identified; 3247 (43.2%) were treated surgically. The percentage of patients receiving surgery increased from 39.3% in 2000 to 46.4% in 2012 (p < 0.001). After adjustment for potential confounders, increased age, increased ICD-9 derived injury severity scores (ICISS) and more recent year were associated with an increased proportion of patients receiving surgical treatment (p < 0.001). Medicaid payer status (p < 0.001) and admission to a children’s hospital (p = 0.045) were associated with a lower proportion of surgical treatment. CONCLUSION: The rate of operative treatment of paediatric proximal humerus fractures increased over time between 2000 and 2012. Increased surgical rates were independently associated with older age, increased ICISS, treatment at a non-children’s hospital and non-Medicaid insurance status. Further study is needed to provide evidence to support improved outcomes after operative treatment of paediatric proximal humerus fractures. LEVEL OF EVIDENCE IV: The British Editorial Society of Bone & Joint Surgery 2018-04-01 /pmc/articles/PMC5902743/ /pubmed/29707048 http://dx.doi.org/10.1302/1863-2548.12.170220 Text en Copyright © 2018, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Cruz Jr, A. I. Kleiner, J. E. Gil, J. A. Goodman, A. D. Daniels, A. H. Eberson, C. P. Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title | Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title_full | Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title_fullStr | Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title_full_unstemmed | Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title_short | Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
title_sort | inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012 |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902743/ https://www.ncbi.nlm.nih.gov/pubmed/29707048 http://dx.doi.org/10.1302/1863-2548.12.170220 |
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