title: The impact of metabolic syndrome on inpatient outcomes after isolated ankle fractures.
abstract: BACKGROUND
  Metabolic syndrome has been associated with increased morbidity following surgical procedures, yet its impact in acute orthopaedic trauma remains unclear. The purpose of this study was to evaluate the influence of metabolic syndrome on in-hospital (1) complications, (2) length of stay, and (3) nonroutine discharge in patients sustaining an isolated ankle fracture.
  
  
  METHODS
  Using the National Health Discharge Survey (NHDS) database for the years 2001 through 2007, an estimated 669 841 patients with isolated ankle fractures treated operatively were identified and separated into groups with and without metabolic syndrome. Multivariable binary logistic regression analysis was performed for each of the outcome variables.
  
  
  RESULTS
  Metabolic syndrome was an independent risk factor for increased nonroutine discharge (OR = 1.8) and the development of in-hospital complications (OR = 2.1). The presence of metabolic syndrome was not an independent risk factor for prolonged hospital stay.
  
  
  CONCLUSIONS
  Patients with metabolic syndrome sustaining an isolated ankle fracture are at increased risk for in-hospital complications and a less rapid return of independent functional mobility, as evidenced by the higher need for posthospitalization care.
  
  
  METHODS
  Level III, epidemiologic study.
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.forename: Arjan G J
authors.initials: AG
authors.lastname: Bot
authors.forename: David
authors.initials: D
authors.lastname: Ring
authors.forename: A Holly
authors.initials: AH
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000601:surgery*; D016512:Ankle Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D019637:Orthopedic Procedures; D012307:Risk Factors
keywords: ankle fracture; complications; discharge; epidemiology; metabolic syndrome; mortality; outcome studies; perioperative; risk factors; trauma