Socioeconomic Status Affects Postoperative Time to Union in Pediatric Patients with a Surgically Treated Fracture

JBJS Open Access · 9 authors, 3 centres

AI SUMMARY

FIDELITY 100%

POPULATIONPediatric patients aged 3 to 17 years with surgically treated long-bone fractures at a Level-I pediatric trauma center

INTERVENTIONSurgical fixation of long-bone fractures

COMPARISONPatients stratified by area-level socioeconomic status (median household income and Child Opportunity Index)

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

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TL;DR

This retrospective cohort study of 395 pediatric patients with surgically treated long-bone fractures found that lower socioeconomic status, measured by median household income and Child Opportunity Index, was significantly associated with longer time to fracture union when controlling for other demographic variables.

Full summary

790 CHARS

A retrospective review was conducted of 395 pediatric patients aged 3 to 17 years treated for long-bone fractures at a Level-I pediatric trauma center between January 2010 and June 2020. SES was assessed using ZIP code-level median household income (MHI) and Child Opportunity Index (COI). Linear regression controlling for demographic variables showed time to union increased by 9.6 days for each $10,000 decrease in MHI and by 6.8 days for each 10-unit decrease in COI (p < 0.001). Logistic regression indicated odds of delayed union (>4 months) increased by 29% per $10,000 MHI decrease and by 19% per 10-unit COI decrease (p < 0.001). Limitations include the retrospective single-center design and a predominantly White (97%) and Hispanic (51%) sample, which may limit generalizability.

PICO

PPOPULATION

Pediatric patients aged 3 to 17 years with surgically treated long-bone fractures at a Level-I pediatric trauma center

IINTERVENTION

Surgical fixation of long-bone fractures

OOUTCOME

Time to radiographic fracture union and union status

STUDY TYPE

cohort

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10358791

Socioeconomic Status Affects Postoperative Time to Union in Pediatric Patients with a Surgically Treated Fracture

JBJS Open Access

READ THE FULL PAPER

ABSTRACT

Background: Fractures account for 10% to 25% of all pediatric injuries, and surgical treatment is common. In such cases, postoperative healing can be affected by a number of factors, including those related to socioeconomic status (SES). The purpose of this study was to investigate the relationship between time to fracture union and SES, which was measured with use of the median household income (MHI) and Child Opportunity Index (COI). Methods: A retrospective review was conducted of pediatric patients with a long-bone fracture that had been surgically treated at a Level-I pediatric trauma center between January 2010 and June 2020. Demographic and relevant medical data were collected. Patients were sorted into union and nonunion groups. The ZIP code of each patient was collected and the MHI and COI of that ZIP code were identified. Income brackets were created in increments of $10,000 ranging from $20,000 to $100,000, with an additional category of >$100,000, and patients were sorted into these groups according to MHI. Comparisons among the income groups and among the union status groups were conducted for each of the collected variables. A multiple regression analysis was utilized to determine the independent effect of each variable on time to union. Results: A total of 395 patients were included in the final sample, of whom 51% identified as Hispanic. Patients in the union group had a higher mean COI and MHI. Nonunion occurred in only 8 patients. Patients who achieved fracture union in ≤4 months had a significantly higher mean COI and MHI. When controlling for other demographic variables, the time to union increased by a mean of 9.6 days for every $10,000 decrease in MHI and increased by a mean of 6.8 days for every 10-unit decrease in the COI. Conclusions: The present study is the first, to our knowledge, to investigate the relationship between SES and time to fracture union in pediatric patients. When controlling for other demographic factors, we found a significant relationship between SES and time to union in pediatric patients with a surgically treated fracture. Further investigations of the relationship between SES and time to union in pediatric patients are needed to determine potential mechanisms for this relationship. Level of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

CITATION EXPORT

David M. Heath, Abdullah N. Ghali, David A. Momtaz et al.. Socioeconomic Status Affects Postoperative Time to Union in Pediatric Patients with a Surgically Treated Fracture. JBJS Open Access. (2023). https://doi.org/10.2106/JBJS.OA.22.00137

AUTHORS

9 · 3 CENTRES

David M. Heath, Abdullah N. Ghali, David A. Momtaz, Sarah Nagel, Rishi Gonuguntla, Shwetha Menon, Hari N. Krishnakumar, Matthew R. Landrum, Grant D. Hogue

1Department of Orthopaedics, UT Health San Antonio, San Antonio, Texas
2Department of Orthopaedics, Baylor College of Medicine, Houston, Texas
3Department of Orthopaedics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts