Outpatient lower extremity fracture surgery: should we be concerned?

Eur J Orthop Surg Traumatol. 2022 May;32(4):719-723. doi: 10.1007/s00590-021-03029-6. Epub 2021 Jun 8.

Abstract

Purpose: With rising healthcare costs and insurance push against non-emergent hospital admission, lower extremity fracture treatment is shifting toward outpatient procedures over inpatient hospitalizations. This study compares outcomes for fractures treated as inpatient versus outpatient.

Methods: We conducted a retrospective review of lower extremity fracture patients. We collected demographics, injury information, hospital course, and complication data. Length of stay was categorized as "inpatient" and "outpatient" based a 24-h hospital stay cutoff. Data analysis included differences between cohorts with regards to readmissions and complications.

Results: We identified 229 patients who met inclusion criteria. Inpatient versus outpatient status was predictive of in-hospital complications; however, inpatient versus outpatient status did not predict 1-year readmission.

Conclusion: Outpatient surgery is safe and effective. As the population increases and ages, low-risk surgeries should be considered for outpatient rather than inpatient stays to lower costs, save resources, and reduce complications.

Keywords: Inpatient; Outpatient; ‘Hospital costs’; ‘Lower extremity, fractures’.

MeSH terms

  • Ambulatory Surgical Procedures* / adverse effects
  • Fractures, Bone* / complications
  • Hospitalization
  • Humans
  • Lower Extremity / surgery
  • Outpatients
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies