Is Area Deprivation Index Associated With Delays in Surgical Treatment of Acute Scaphoid Fractures?

IF 1.3 Q2 ORTHOPEDICS

HAND Pub Date : 2026-10-01 Epub Date: 2025-12-01 DOI:10.1177/15589447251397006

Tania P Mamdouhi, Carol A Janney, Elinor Stern, Zhaorui Wang, Daniel Yang, T K Kevin Chan

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引用次数: 0

Abstract

Background: Social determinants of health greatly influence medical outcomes. The Area Deprivation Index (ADI) assesses socioeconomic disparities. This study evaluates the impact of geographic socioeconomic disadvantage on the time to scaphoid open reduction and internal fixation (ORIF).

Methods: A retrospective chart review from 2012 to 2023 analyzed time to surgery (TTS) with 21- and 28-day cutoffs (TTS₂₁ and TTS₂₈). Patients were categorized into highest (ADI_high) and lowest (ADI_low) national ADI quartiles. Logistic regression and proportional hazards models were built to determine whether ADI status affected time to surgery. The impact of age, sex, race, ethnicity, insurance status, and medical comorbidities on TTS was also assessed.

Results: Among 116 patients (83% male, 17% female), the average TTS was 20.8 ± 27.1 days. For TTS₂₁, mean TTS_≤21 was 8.9 ± 5.2 days versus TTS_>21 was 52.1 ± 35.3 days (P < .05). For TTS₂₈, mean TTS_≤28 was 10.5 ± 6.9 days versus TTS_>28 was 62.7 ± 36.6 days (P < .05). ADI_low and ADI_high quartiles had 30 patients each, with average TTS of 23.1 ± 34.3 and 19.3 ± 25.0 days, respectively, with no significant difference (P = .18).

Conclusion: Significant surgical delays occur when scaphoid ORIF is performed after 21- or 28-day post-injury. Although geographic disadvantage was not identified as a risk in this study due to small sample size, future studies could help clarify the utility in ADI integration into electronic records to identify at-risk patients for more timely surgical intervention.

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面积剥夺指数与急性舟状骨骨折手术治疗延迟有关吗？

背景：健康的社会决定因素极大地影响医疗结果。地区剥夺指数（ADI）评估社会经济差距。本研究评估了地理社会经济劣势对舟状骨切开复位内固定（ORIF）时间的影响。方法：回顾性回顾2012年至2023年的图表，分析21天和28天的截止时间（TTS21和TTS28）。患者被分为最高（ADIhigh）和最低（ADIlow）国家ADI四分位数。建立Logistic回归和比例风险模型来确定ADI状态是否影响手术时间。还评估了年龄、性别、种族、民族、保险状况和医疗合并症对TTS的影响。结果116例患者（男性83%，女性17%），TTS平均为20.8±27.1 d。TTS21≤21的平均TTS为8.9±5.2 d，而TTS21≤21的平均TTS为52.1±35.3 d （P < 0.05）。对于TTS28， TTS≤28的平均值为10.5±6.9天，而TTS bbb28的平均值为62.7±36.6天（P < 0.05）。ADIlow和ADIhigh四分位数各30例，平均TTS分别为23.1±34.3和19.3±25.0天，差异无统计学意义（P = 0.18）。结论：伤后21天或28天后行舟状骨ORIF会出现明显的手术延误。尽管由于样本量小，本研究未将地理劣势确定为风险，但未来的研究可以帮助阐明将ADI集成到电子记录中的效用，以识别有风险的患者，以便更及时地进行手术干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.