title: Isolated sacral injuries: Postoperative length of stay, complications, and readmission.
abstract: OBJECTIVE
  To investigate inpatient length of stay (LOS), complication rates, and readmission rates for sacral fracture patients based on operative approach.
  
  
  METHODS
  All patients who presented to a large tertiary care center with isolated sacral fractures in an 11-year period were included in a retrospective chart review. Operative approach (open reduction internal fixation vs percutaneous) was noted, as well as age, gender, race, and American Society of Anesthesiologists' score. Complications included infection, nonunion and malunion, deep venous thrombosis, and hardware problems; 90-d readmissions were broken down into infection, surgical revision of the sacral fracture, and medical complications. LOS was collected for the initial admission and readmission visits if applicable. Fisher's exact and non-parametric t-tests (Mann-Whitney U tests) were employed to compare LOS, complications, and readmissions between open and percutaneous approaches.
  
  
  RESULTS
  Ninety-four patients with isolated sacral fractures were identified: 31 (30.4%) who underwent open reduction and internal fixation (ORIF) vs 63 (67.0%) who underwent percutaneous fixation. There was a significant difference in LOS based on operative approach: 9.1 d for ORIF patients vs 6.1 d for percutaneous patients (P = 0.043), amounting to a difference in cost of $13590. Ten patients in the study developed complications, with no significant difference in complication rates or reasons for complications between the two groups (19.4% for ORIF patients vs 6.3% for percutaneous patients). Eight patients were readmitted, with no significant difference in readmission rates or reasons for readmission between the two groups (9.5% percutaneous vs 6.5% ORIF).
  
  
  CONCLUSIONS
  There is a significant difference in LOS based on operative approach for sacral fracture patients. Given similar complications and readmission rates, we recommend a percutaneous approach.
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Vasanth
authors.initials: V
authors.lastname: Sathiyakumar
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Hanyuan
authors.initials: H
authors.lastname: Shi
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Thakore
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Young M
authors.initials: YM
authors.lastname: Lee
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: David
authors.initials: D
authors.lastname: Joyce
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Jesse
authors.initials: J
authors.lastname: Ehrenfeld
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: William T
authors.initials: WT
authors.lastname: Obremskey
authors.affiliation: Vasanth Sathiyakumar, Hanyuan Shi, Rachel V Thakore, Young M Lee, David Joyce, Jesse Ehrenfeld, William T Obremskey, Manish K Sethi, the Vanderbilt Orthopaedic Institute Center for Health Policy, Medical Center East, South Tower, Nashville, TN 37232, United States.
authors.forename: Manish K
authors.initials: MK
authors.lastname: Sethi
keywords: Length of stay; Open reduction and internal fixation; Percutaneous complications; Readmissions; Sacral fractures