Complications, Complication Rates, And 90 Day Readmission...

Abstract With the recent focus on dramatic cuts and escalating healthcare costs in the United States, a new center of attention has been placed upon postoperative readmission and reimbursement. Although sacral fractures constitute a large component of all pelvic fractures, there is relatively little data investigating differences in the postoperative length of stay (LOS), the complication rates, and the 90-day readmissions for these patients. The purpose of this paper was to investigate differences in postoperative length of stay, complication rates, and 90-day readmission rates for patients with operative isolated sacral fractures. All patients who presented to a large tertiary care center with isolated sacral fractures in an 11 year†¦show more content†¦This significant difference in LOS between ORIF vs. percutaneous fixation of sacral injuries leading to an average difference of $13,590 in average inpatient cost highlights predicative information to potentially reduce perioperati ve costs related to sacral fractures for orthopaedic surgeons. INTRODUCTION 45% of all pelvic fractures are sacral injuries [1]. They can occur in high energy collisions, with motor vehicle accidents making up 57% of these crush injuries [2]. Traumatic force can lead to compression, which then precipitates neurological complications [3]. For this reason, these fractures are musculoskeletal injuries requiring emergent action at trauma centers to reduce the risk of complications. While open reduction and internal fixation (ORIF) methods permits direct visualization of the injured pelvis, there are highly variable wound complication rates ranging from 3.9% to 27% [4]. Critics of ORIF are concerned about the extremely high risk of infection post-operatively, which can increase from 18% to 27% for fractures treated early and late, respectively [5]. It is reasonable to consider a more minimally invasive technique such as percutaneous fixation, which uses screws to mechanically stabilize an unstable sacrum [6]. Percutaneous fixation with iliosacral screws, for example, have led to decreases in surgical time, exposure related hazards, and soft-tissue disruption [7]. With the recent focus on dramatic cuts and