Hand in hand with healthcare: A nationwide analysis of emergency department encounters for hand ailments

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-02-11 DOI:10.1016/j.jcot.2025.102943

Heather A. Peluso , Sajni S. Parikh , Marwan S. Abougergi , Adam C. Walchak

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引用次数: 0

Abstract

Background

Hand ailments are frequent reasons for emergency department (ED) visits in the United States. This study analyzed the incidence, causes, outcomes, predictors of hospitalization, and healthcare utilization patterns nationwide.

Methods

This retrospective cohort study utilized data from the Nationwide Emergency Department Sample and National Readmission Database from 2016 to 2021. It included patients with a principal diagnosis of hand or wrist complaints.

Results

The study included 29,109,534 ED visits for hand ailments. The mean patient age was 36 years. Most patients were Caucasian (61 %), healthy (89 % Charlson Comorbidity score of 0), male (57 %), and from lower income brackets (60 %). Most injuries were unintentional (71 %), with hand lacerations being the most common reason for presentation, followed by closed distal radius fractures. Most patients were discharged home (96 %). Predictors of admission included older age (adjusted odds ratio (aOR) per decade: 1.03; 95 % Confidence Interval (CI): 1.02–1.03; p < 0.01), higher Charlson index (aOR:1.69; CI:1.65–1.73; p < 0.01), Medicaid insurance or uninsured (aOR:1.26; CI:1.18–1.36, aOR:1.25; CI:1.16–1.36; p < 0.01, respectively), and presentation at level I metropolitan trauma teaching hospitals (aOR:3.48; CI:2.98–4.07; p < 0.01). Admission rates increased by 21 % in 2020 compared to 2016. Healthcare expenditure was a staggering $105 billion in total ED and inpatient hospitalization charges. Expenditure increased significantly, surpassing inflation-adjusted rates.

Conclusions

Our analysis of 29 million patients highlights the healthcare burden posed by hand ailments, with lacerations being the most prevalent concern in emergency settings. Admission and readmission rates were influenced by age, comorbidities, socioeconomic status, insurance type, and hospital characteristics. This study provides a basis for targeted interventions in patient outcome enhancement and resource allocation. Limitations include the reliance on ICD-10-CM coding in the absence of clinical data, which may impact the accuracy of case identification and classification.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.