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ESRA19-0619 Ankle fractures re-admission and pain management
  1. H Mcgrath1 and
  2. J Harty2
  1. 1University Hospital Limerick, Anaesthetics, Limerick, Ireland
  2. 2Cork University Hospital, Orthopaedic Surgery, Cork, Ireland

Abstract

Background and aims Ankle fracture readmission can occur due to numerous risk factors that has implications for surgeries and hospital administration. To examine the readmission rates for ankle fracture patients focusing on risk factors, pain management, and complications.

Methods This study focuses on patients admitted to the orthopaedic service of Cork University Hospital over a one year period (2014) with a special interest in ankle fracture. Statistical analysis and inclusion/exclusion criteria were applied.

Results Study examined ankle fracture patients over the 10-year period, 1,697 admissions relating to 1,579 unique patients. Binary logistic regression was performed to assess the impact of various factors on readmission. Seventeen independent variables were included in the model: sex, primary diagnosis of ankle fracture, injury caused by external mechanical forces, presence of ankle dislocation, fracture management – open reduction internal fixation, fracture management – closed reduction, fracture management – other, general anaesthesia, regional anaesthesia, other anaesthesia, experience of complications related to trauma or medical/surgical care, physiotherapy intervention, other allied health intervention, current tobacco use, cardiovascular disease, discharge to home, and discharge to another hospital under non-emergency conditions.

Conclusions This study demonstrates the importance of controlling post-operative complications in ankle fracture surgery. Readmission rates can be prevented with identification of high-risk patient groups such as associated with causes of delayed wound healing such as smoking, diabetes, and raised BMI. Ankle fracture management is dependent on the type of fracture and mechanism of Injury. Readmission profile is essential if strategies are to be developed to reduce cost and surgery time.

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