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Ankle Fracture Surgery – Diabetics fare worse than non-diabetics

A study at Duke Univ. has shown that the surgical outcome of surgery for fracture of ankle is not as good as in non-diabetics. The results were published Aug. 15, 2005, in the Journal of Bone and Joint Surgery.//

In the largest analysis of its kind, Duke University Medical Center researchers have found that patients with diabetes who require surgery for ankle fractures have significantly higher rates of complications and higher hospital costs compared to non-diabetic patients.

The researchers noted -

- Dabetics experienced one additional day of hospitalization (an average of 4.7 vs. 3.6 days) with costs approximately 20 percent higher ($12,898 vs. $10,794).
- Dabetics had higher mortality rates (0.26 percent vs. 0.11 percent)
- Hgher rates of post-operative complications (4.63 percent vs. 3.27 percent).

Ankle fractures are one of the most common injuries treated by orthopedic surgeons, and the study's findings provide guidance on how to improve the care for these patients and reduce health care expenditures.

"While a number of smaller studies have indicated that diabetic patients tended to have worse outcomes after ankle surgery, this is the first large-scale analysis of a cross-section of patients across the U.S.," said Shanti Ganesh, M.P.H., lead author of the study and fourth-year year medical student at Duke University School of Medicine.

"This analysis demonstrated that diabetic patients, no matter how severe the ankle fracture, were more likely to experience higher rates of post-operative complications, mortality, and non-routine discharge, with accompanying longer lengths of hospital stay and higher hospital charges," Ganesh said.

For their analysis, the Duke team consulted the Nationwide Inpatient Samples (NIS) database and identified 169,598 patients who underwent surgery for ankle fractures. The NIS, sponsored by the U.S. Agency for Healthcare Research and Quali
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