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. 2024 Jun 25:54:102476.
doi: 10.1016/j.jcot.2024.102476. eCollection 2024 Jul.

Hospital teaching status is an independent predictor of surgical intervention of distal radius fractures

Dustin R Biron  1 , Akhil Katakam  1 , Robert L DalCortivo  1 , Irfan H Ahmed  1 , Michael M Vosbikian  1
Affiliations

Hospital teaching status is an independent predictor of surgical intervention of distal radius fractures

Dustin R Biron et al. J Clin Orthop Trauma. .

Erratum in

Abstract

Background: Distal radius fractures are among the most common orthopaedic injuries and are managed both surgically and non-surgically. To date, no study has examined the role hospital teaching status plays in the rates of surgical intervention.

Methods: The Nationwide Inpatient Sample (NIS) was queried for years 2003-2014. Patients with a distal radius fracture were identified using International Classification for Disease, Ninth Revision (ICD-9) disease codes. Surgical intervention was determined using ICD-9 procedure codes. Exclusion criteria were patients younger than age 18, polytrauma, open fractures, records with missing data, and records where the primary procedure was something other than open reduction of a radius or ulna fracture, closed reduction of a radius or ulna fracture, or blank. Chi-squared tests were run for demographic and socioeconomic data to identify significant variables. Significant variables were then included alongside hospital teaching status in a binomial logistic regression model. Significance was defined as P < 0.05.

Results: A weighted total of 98,831 patients were included in the study. Of those, 45,234 (45.8 %) were treated at teaching hospitals. Patients in teaching hospitals were more likely to be younger, male, non-white, and non-Medicare insured than non-teaching hospitals. Injuries were treated surgically in 64.6 % of total cases. Surgical intervention was more common in teaching hospitals than non-teaching hospitals (69.1 % vs. 60.8 %, P < 0.01). After controlling for demographic and socioeconomic factors, patients at teaching hospitals were 31 % more likely to undergo surgical treatment than those at non-teaching hospitals. Other factors that were independently predictive of surgical treatment were age, race, and insurance type.

Conclusion: In the setting of distal radius fractures, teaching hospitals have higher rates of surgical intervention than non-teaching hospitals. These results suggest that the involvement of medical trainees may play a role in the surgical decision-making process.

Keywords: Distal radius; NIS; Outcomes; Residents; Teaching.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Michael Vosbikian reports a relationship with Journal of Bone and Joint Surgery Inc that includes: consulting or advisory. Michael Vosbikian reports a relationship with ePlasty that includes: board membership.

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