Increased Rates of Readmission, Reoperation, and Mortality following Open Reduction and Internal Fixation of Ankle Fractures Are Associated with Diabetes Mellitus

The purpose of this large-scale retrospective study was to calculate the increased risk for postoperative unplanned readmission, unplanned reoperation, and mortality after ankle fracture ORIF in patients with diabetes mellitus (DM). Patients who underwent ORIF for ankle fractures from 20to 2015 were identified in ACS-NSQIP database. Patient demographics and 30-day postoperative readmission, reoperation, and mortality rates were compared in 2,044 patients with DM and 15,420 patients without DM. Adjusted odds ratios controlling for age differences were calculated for each parameter with a 95% confidence interval. Patient factors and pre-operative laboratory statistics are summarized in Figure D, and the distribution of ankle fractures for each group are shown in Figure A and B. Comparing patients with DM vs. without DM, the rate of readmission was 4.35% vs. 1.50%, rate of reoperation was 2.30% vs. 0.75%, and rate of mortality was 0.73% vs. 0.21%. As shown in Figure C, patients with DM had a 2.66 times increased risk of readmission, a 2.76 increased risk of reoperation, and a 2.34 increased risk of mortality. Interestingly, we also found a 22.increased risk of amputation, though the rate of amputation in both groups was very small. Ankle fractures requiring ORIF in patients with DM are serious events and associated with substantial morbidity.