Abstract
PURPOSE: To assess and compare the associative value of comorbidity fracture-specific index (CFI) versus the Charlson comorbidity index (CCI) in identifying patients at risk for early complications after open reduction and internal fixation (ORIF) of distal radius fractures (DRFs).
METHODS: We performed a single-center retrospective cohort study including patients ≥40 years who underwent ORIF for closed DRF using a volar locking plate with a minimum of 1 year follow-up. CCI and CFI scores were calculated based on comorbidities over the prior 15 years. The primary outcome was 90-day postoperative complications. We used logistic regression to compare CCI and CFI and their association with complications, adjusting for age, sex, smoking status, and ethnicity. We used Pearson correlation and the intraclass correlation coefficient to assess the relationship and agreement between CCI and CFI.
RESULTS: Among the 317 patients, 16.7% (n = 53) experienced complications. There were no statistically significant differences in CCI or CFI in patients with and without complications. After adjusting for covariates, each increase by 1 in CCI and CFI, increased the odds of complications; however, these effects were not statistically significant. CCI and CFI were strongly correlated and showed high agreement.
CONCLUSIONS: CCI and CFI scores did not significantly differ between patients with and without complications after DRF and were not significantly associated with postoperative complications after adjusting for covariates. The strong correlation and agreement between CCI and CFI suggest they capture a similar comorbidity burden in this patient population. Neither CCI nor CFI demonstrated good discriminative ability in identifying patients at risk for early complications after ORIF of DRF.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.