Diabetics with ankle fractures have longer lengths of stay, more health care costs

New research from NYU Langone orthopaedic surgeons finds patients with diabetes who fracture their ankle incur significantly more inpatient health care costs compared to patients who do not have diabetes.

The research, led by Kenneth A. Egol, MD, a professor and vice chair of education in the Department of Orthoapedic Surgery at NYU Langone, showed patients with diabetes who undergo ankle fracture surgery have significantly longer lengths of stay and total hospital charges compared to non-diabetics, with worse trends seen among patients with complicated disease.

NYU Langone researchers looked at nearly 59,000 individuals who underwent open reduction and internal fixation (ORIF) surgery to fix an ankle fracture, as recorded by the New York Statewide Planning and Research Cooperative System (SPARCS) database.

About 7,500 patients had diabetes, nearly 1,100 of whom had complicated disease that caused renal or neurologic manifestations.

The researchers found that patients with diabetes were more likely to incur significantly greater hospital charges (mean: $26,491 diabetes versus $20,428 nondiabetes) and have significantly longer lengths of stay (5.8 days diabetes compared with 3.9 days nondiabetes) compared to patients without diabetes.

A similar trend was seen when patients with complicated diabetes were compared to patients with diabetes alone. Such data may be used to convince payers to increase hospital reimbursements for diabetics undergoing ankle fracture surgeries.

"With increasing U.S. diabetes rates, more orthopaedic surgeons are faced with treating the unique needs of patients in this population." says Dr. Egol. "Better understanding of the complications and care considerations among diabetics could allow health care professionals better manage and treat this growing group of patients and keep down medical costs."