Incidence of pulmonary embolism following surgical treatment of metatarsal fractures.
BACKGROUND
The purpose of this study was to identify the rates of readmission to the hospital for pulmonary embolism following open reduction and internal fixation of metatarsal fractures using observational, population-based data from all inpatient admissions in California over an 11-year period.


METHODS
We identified patients undergoing open reduction and internal fixation of a metatarsal fracture in the years 1995 to 2005 as inpatients using California's discharge database. The outcomes analyzed included readmission within 90 days of surgery for pulmonary embolism. Logistic regression models were used to estimate the impact of patient factors such as age, race/ethnicity and gender in predicting the rates of thromboembolic disease.


RESULTS
A total of 1,477 metatarsal ORIF procedures were performed as inpatients during the study period. We identified four patients (0.27%) readmitted with pulmonary embolism within 90 days of their initial ORIF procedure. There were three (0.20%) cases of mortality, none of which occurred in the four patients readmitted with pulmonary embolism. Given the low incidence, we did not identify age, gender, or race/ethnicity as statistically significant predictors of a higher risk of thromboembolic disease.


CONCLUSIONS
The rate of readmission for pulmonary embolism was low. This suggests that the routine use of thromboprophylaxis may not be necessary for isolated metatarsal fractures to prevent pulmonary embolism.
Soohoo
Nelson F
NF
University of California, Los Angeles, Orthopaedic Surgery, Los Angeles, CA 90095, USA. nsoohoo@mednet.ucla.edu
Farng
Eugene
E
Zingmond
David S
DS
D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012307:Risk Factors; D013639:Tarsal Bones / Q000293:injuries*; D016896:Treatment Outcome; D055815:Young Adult