Incidence and Predictors of Complications of Acute Achilles Tendon Rupture Repair at Hamad ...

12 Pages·2014·0.98 MB·English

Incidence and Predictors of
Complications of Acute Achilles Tendon
Rupture Repair at Hamad General
Hospital, Doha, Qatar
Authors
Sameh M. Abolfotouh
Mohammed Al Dosari
Nader Elsaid
Mostafa A Abolfotouh
Incidence and Predictors of Complications of Acute Achilles
Tendon Rupture Repair at Hamad General Hospital, Doha,
Qatar

• Presenter: Sameh M Abolfotouh, MD

My disclosure is in the
Final AOFAS Mobile App.
I have no potential conflicts with
this presentation.
Aims of Study
 To estimate the incidence and pattern of
complications after Achilles tendon repair, and
 To determine the significant predictors of post-
repair infection.

Methods
 Study setting:
Hamad General Hospital.
 Study Design:
Retrospective cohort study
 Study subjects:
All patients presented at HGH during the period of June 2010 to
June 2012 with Achilles rupture ( n=102).
Sample characteristics
Diabetes Mellitus
Rupture type Gender
Female
Yes
4%
4%
Partial
48% 52% Complete
96% 96%
No Male
Cause of rupture
Slab application
Injury type
Sharp object
Sports-related
Posterior
Closed
14%
19%
16%
42%
58%
Anterior
70%
81%
Bathroom
injury Open
Incidence of complications After
Achilles repair at HGH
9.8
10
8
5.9
6
%
4
2 2
0
Infection
Stiffness
Revision
Association of post-operative infection with Patient &
injury characteristics
%
Gender Cause of Rupture Slab Close vs Open Diabetes
30
rupture type application
25.0 75
25
20
15 14.3
10.8
10.2
9.1
10 9.2 9.4 9.1
8.7 7.1
5.3
5
0
Male Female Sport Others Complet e Partial Anterior Posterior Close Open Yes None
related
(p=0.342) (p=0.624) (p=0.896) (p=0.951) (p=0.683) (p=0.003*)
Extended scale
Association of post-operative infection with
management characteristics
51.10
40 1.735 1.70 4.5 4.20
37.10 51
20
35 30.41 1.73 1.65 4
1.725 1.72 1.60 3.5 50.5 19.04
30 19
25 11.7.7125 1.60 3 2.70 es 50
Years 20 № 1.71 № 11..5505 1.49 Days 2.25 minut 49.5 ours 18
1.705 49.50 h
15 16
1.7 1.45 1.5 49 14.40
10
1.695 1 14
5 1.69 1.60 1.40 0.5 48.5
0
Age Sutures Antibiotics Length of stay Surgical time Time to surgery
p=0.18 p=0.41 p=0.49 p=0.044* p=0.80 p=0.37
Infected Non infected
ROC Curve of infection with hospital days
1.00
.90
2.5 days

.80

.70
y
.60
t
vi
i
t
i .50
s
n
e
S .40
.30
.20
.10
0.00
-.20 0.00 .20 .40 .60 .80 1.00
1 - Specificity
Diagonal segments are produced by ties.
2x2 table of hospital days and infection after
Achilles repair
Infection No Infection Total
2.5 or more days 8 (80.0) 42 (45.7) 58

less than 2.5 days 2 (20.0) 50 (54.3) 52

Total 10 92
Sensitivity = 8/10= 80%
Specificity = 50/92=54.3%
Good
Positive predictive value (PPV)= 8/58=14%
Negative
Negative predictive value (NPP)= 50/52= 96.2%
Test
Regression analysis of post-repair infection

Beta
adjP-value Adj. OR (95% CI)
S.E.

Diabetes

No 0 1.429 0.017* 30.587 (1.85-503.41)
3.421
Yes 1

Hospital days 1.459
0.893 0.102 4.30 (0.74-24.79)
(Days)
Age 0.010
(Years)
0.040 0.796 1.01 (0.93-1.09)
Constant
-3.808
1.413 0.007