Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database
Purpose: The purpose of this study was to use a national database to determine if either surgical or nonsurgical management of pyogenic flexor tenosynovitis (PFT) led to specific superior outcomes. Methods: International Classification of Diseases, Tenth Revision codes were used to identify patients...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Journal of Hand Surgery Global Online |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S258951412400183X |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832586258688245760 |
|---|---|
| author | Justin D. Sawyer, MD Justin Davis, MD Steven Scaife, MS Michael W. Neumeister, MD Timothy H.F. Daugherty, MD |
| author_facet | Justin D. Sawyer, MD Justin Davis, MD Steven Scaife, MS Michael W. Neumeister, MD Timothy H.F. Daugherty, MD |
| author_sort | Justin D. Sawyer, MD |
| collection | DOAJ |
| description | Purpose: The purpose of this study was to use a national database to determine if either surgical or nonsurgical management of pyogenic flexor tenosynovitis (PFT) led to specific superior outcomes. Methods: International Classification of Diseases, Tenth Revision codes were used to identify patients admitted with PFT from the National Readmissions Database for the years 2016–2019. All patients had been admitted initially and treated with either surgical or nonsurgical management. Baseline characteristics were determined, and in those who were readmitted, the top 10 diagnoses of 90-day readmissions were identified. Risk factors for readmission were identified using a regression analysis. Ninety-day readmission rates, amputation rates, and length of stay between the groups were compared, as these are outcomes that can be reviewed from the database. Results: The overall 90-day readmission rate was 13.25%. Infectious complications from the original diagnosis of PFT were the leading causes of readmission. Variables associated with 90-day readmission were higher Charlson comorbidity index, hypertension, Medicaid insurance, longer initial length of hospital stay, tobacco use, and nonsurgical management. Ninety-day readmission rates and amputation rates were higher in the nonsurgical group. Conclusions: In patients with PFT, surgical intervention may prevent hospital readmissions and reduce the likelihood of amputation. Readmission is more likely in patients with more medical comorbidities, tobacco users, and lower socioeconomic status. Type of study/level of evidence: Prognosis IIC. |
| format | Article |
| id | doaj-art-50000262c8a24991ab90b7b2bca91928 |
| institution | Kabale University |
| issn | 2589-5141 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj-art-50000262c8a24991ab90b7b2bca919282025-01-26T05:04:37ZengElsevierJournal of Hand Surgery Global Online2589-51412025-01-0171913Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions DatabaseJustin D. Sawyer, MD0Justin Davis, MD1Steven Scaife, MS2Michael W. Neumeister, MD3Timothy H.F. Daugherty, MD4Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, ILInstitute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, ILCenter for Clinical Research, Southern Illinois University School of Medicine, Springfield, ILInstitute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, ILInstitute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL; Corresponding author: Timothy H.F. Daugherty, MD, Institute for Plastic Surgery, Southern Illinois University School of Medicine, 747 N. Rutledge Street No. 3, Springfield, IL 62711.Purpose: The purpose of this study was to use a national database to determine if either surgical or nonsurgical management of pyogenic flexor tenosynovitis (PFT) led to specific superior outcomes. Methods: International Classification of Diseases, Tenth Revision codes were used to identify patients admitted with PFT from the National Readmissions Database for the years 2016–2019. All patients had been admitted initially and treated with either surgical or nonsurgical management. Baseline characteristics were determined, and in those who were readmitted, the top 10 diagnoses of 90-day readmissions were identified. Risk factors for readmission were identified using a regression analysis. Ninety-day readmission rates, amputation rates, and length of stay between the groups were compared, as these are outcomes that can be reviewed from the database. Results: The overall 90-day readmission rate was 13.25%. Infectious complications from the original diagnosis of PFT were the leading causes of readmission. Variables associated with 90-day readmission were higher Charlson comorbidity index, hypertension, Medicaid insurance, longer initial length of hospital stay, tobacco use, and nonsurgical management. Ninety-day readmission rates and amputation rates were higher in the nonsurgical group. Conclusions: In patients with PFT, surgical intervention may prevent hospital readmissions and reduce the likelihood of amputation. Readmission is more likely in patients with more medical comorbidities, tobacco users, and lower socioeconomic status. Type of study/level of evidence: Prognosis IIC.http://www.sciencedirect.com/science/article/pii/S258951412400183XHand infectionPyogenic flexor tenosynovitis |
| spellingShingle | Justin D. Sawyer, MD Justin Davis, MD Steven Scaife, MS Michael W. Neumeister, MD Timothy H.F. Daugherty, MD Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database Journal of Hand Surgery Global Online Hand infection Pyogenic flexor tenosynovitis |
| title | Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database |
| title_full | Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database |
| title_fullStr | Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database |
| title_full_unstemmed | Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database |
| title_short | Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database |
| title_sort | operative versus nonoperative management of pyogenic flexor tenosynovitis an analysis of the national readmissions database |
| topic | Hand infection Pyogenic flexor tenosynovitis |
| url | http://www.sciencedirect.com/science/article/pii/S258951412400183X |
| work_keys_str_mv | AT justindsawyermd operativeversusnonoperativemanagementofpyogenicflexortenosynovitisananalysisofthenationalreadmissionsdatabase AT justindavismd operativeversusnonoperativemanagementofpyogenicflexortenosynovitisananalysisofthenationalreadmissionsdatabase AT stevenscaifems operativeversusnonoperativemanagementofpyogenicflexortenosynovitisananalysisofthenationalreadmissionsdatabase AT michaelwneumeistermd operativeversusnonoperativemanagementofpyogenicflexortenosynovitisananalysisofthenationalreadmissionsdatabase AT timothyhfdaughertymd operativeversusnonoperativemanagementofpyogenicflexortenosynovitisananalysisofthenationalreadmissionsdatabase |