Abstract
Background While previous studies have investigated the association between bleeding disorders
and outcomes with hip or knee surgeries, no studies have investigated the association
between bleeding disorders and outcomes in upper extremity surgery.
Questions/Purposes The purpose of this study was to investigate if a past history of bleeding disorders
is associated with which, if any postoperative complications for patients receiving
distal radius fracture open reduction internal fixation.
Patients and Methods Patients undergoing operative treatment for distal radius fracture from 2007 to 2018
were identified in the National Surgical Quality Improvement Program database. Patients
were stratified into two cohorts: patients with a bleeding disorder and patients without
a bleeding disorder. In this analysis, 30-day postoperative complications were assessed,
as well as mortality, extended length of stay, reoperation, and readmission. Bivariate
and multivariate analyses were performed.
Results Of the 16,489 total patients undergoing operative treatment for distal radius fracture,
16,047 patients (97.3%) did not have a bleeding disorder, whereas 442 (2.7%) had a
bleeding disorder. Following adjustment on multivariate analyses, an increased risk
of postoperative transfusion requirement (odds ratio [OR] 17.437; p = 0.001), extended length of hospital stay more than 3 days (OR 1.564; p = 0.038), and readmission (OR 2.515; p < 0.001) were seen in patients with a bleeding disorder compared to those without
a bleeding disorder.
Conclusion History of bleeding disorders is an independent risk factor for transfusions, extended
length of stay, and readmission. We recommend a multidisciplinary team approach to
addressing bleeding disorders before patients receive distal radius fracture open
reduction internal fixation.
Level of Evidence Level III, retrospective study.
Keywords
distal radius fracture - open reduction internal fixation - bleeding disorder - complications
