Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients
Background:. Operative fixation of distal radius fractures (DRFs) in high-demand patients may provide functional benefit, particularly in the setting of significant displacement. Whether social determinants of health (SDOH) and race impact treatment remain unclear. The purpose of this study was to d...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-02-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006522 |
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| author | Nicole J. Newman-Hung, MD Amil R. Agarwal, BA Ambika E. Paulson, MD Uma Srikumaran, MD, MBA, MPH Dawn Laporte, MD Lauren E. Wessel, MD |
| author_facet | Nicole J. Newman-Hung, MD Amil R. Agarwal, BA Ambika E. Paulson, MD Uma Srikumaran, MD, MBA, MPH Dawn Laporte, MD Lauren E. Wessel, MD |
| author_sort | Nicole J. Newman-Hung, MD |
| collection | DOAJ |
| description | Background:. Operative fixation of distal radius fractures (DRFs) in high-demand patients may provide functional benefit, particularly in the setting of significant displacement. Whether social determinants of health (SDOH) and race impact treatment remain unclear. The purpose of this study was to determine whether adverse SDOH modifiers and race are independent predictors of surgical intervention for DRF.
Methods:. A retrospective analysis was conducted using the Medicare Standard Analytical Files of the PearlDiver database of patients with a DRF from 2007 to 2016. Univariate and multivariable regression analyses were performed to observe whether race and adverse SDOH variables were independent predictors of undergoing open reduction internal fixation (ORIF) within 3 weeks of a new diagnosis of DRF after controlling for age and fracture type.
Results:. The average patient age was 76.3 years. A total of 10,697 (13.1%) patients underwent ORIF. Patients who underwent ORIF were less likely to have negative economic and social modifiers of SDOH and had lower odds of being non-White. Patients who underwent surgery also had higher odds of being younger, White, female, and having a type III open fracture.
Conclusions:. In the Medicare population, non-White race and adverse economic and social modifiers of SDOH were independent predictors of undergoing nonoperative treatment of DRF after controlling for age and fracture type. Future studies are needed to further elucidate the nuanced effects of race and SDOH on the management of DRFs. |
| format | Article |
| id | doaj-art-80e79e63ff564d0ab058641736ef5a95 |
| institution | OA Journals |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-80e79e63ff564d0ab058641736ef5a952025-08-20T02:03:35ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-02-01132e652210.1097/GOX.0000000000006522202502000-00014Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare PatientsNicole J. Newman-Hung, MD0Amil R. Agarwal, BA1Ambika E. Paulson, MD2Uma Srikumaran, MD, MBA, MPH3Dawn Laporte, MD4Lauren E. Wessel, MD5From the * Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA† Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, DC‡ School of Medicine, Georgetown University, Washington, DC§ Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Columbia, MD.§ Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Columbia, MD.From the * Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CABackground:. Operative fixation of distal radius fractures (DRFs) in high-demand patients may provide functional benefit, particularly in the setting of significant displacement. Whether social determinants of health (SDOH) and race impact treatment remain unclear. The purpose of this study was to determine whether adverse SDOH modifiers and race are independent predictors of surgical intervention for DRF. Methods:. A retrospective analysis was conducted using the Medicare Standard Analytical Files of the PearlDiver database of patients with a DRF from 2007 to 2016. Univariate and multivariable regression analyses were performed to observe whether race and adverse SDOH variables were independent predictors of undergoing open reduction internal fixation (ORIF) within 3 weeks of a new diagnosis of DRF after controlling for age and fracture type. Results:. The average patient age was 76.3 years. A total of 10,697 (13.1%) patients underwent ORIF. Patients who underwent ORIF were less likely to have negative economic and social modifiers of SDOH and had lower odds of being non-White. Patients who underwent surgery also had higher odds of being younger, White, female, and having a type III open fracture. Conclusions:. In the Medicare population, non-White race and adverse economic and social modifiers of SDOH were independent predictors of undergoing nonoperative treatment of DRF after controlling for age and fracture type. Future studies are needed to further elucidate the nuanced effects of race and SDOH on the management of DRFs.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006522 |
| spellingShingle | Nicole J. Newman-Hung, MD Amil R. Agarwal, BA Ambika E. Paulson, MD Uma Srikumaran, MD, MBA, MPH Dawn Laporte, MD Lauren E. Wessel, MD Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients Plastic and Reconstructive Surgery, Global Open |
| title | Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients |
| title_full | Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients |
| title_fullStr | Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients |
| title_full_unstemmed | Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients |
| title_short | Impact of Race and Social Determinants on Operative Management of Distal Radius Fractures in Medicare Patients |
| title_sort | impact of race and social determinants on operative management of distal radius fractures in medicare patients |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006522 |
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