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The Impact of Metabolic Syndrome on Inpatient Outcomes After Isolated Ankle Fractures

Background: Metabolic syndrome has been associated with increased morbidity following surgical procedures, yet its impact in acute orthopaedic trauma remains unclear. The purpose of this study was to evaluate the influence of metabolic syndrome on in-hospital (1) complications, (2) length of stay, and (3) nonroutine discharge in patients sustaining an isolated ankle fracture. Methods: Using the National Health Discharge Survey (NHDS) database for the years 2001 through 2007, an estimated 669 841 patients with isolated ankle fractures treated operatively were identified and separated into groups with and without metabolic syndrome. Multivariable binary logistic regression analysis was performed for each of the outcome variables. Results: Metabolic syndrome was an independent risk factor for increased nonroutine discharge (OR = 1.8) and the development of in-hospital complications (OR = 2.1). The presence of metabolic syndrome was not an independent risk factor for prolonged hospital stay. Conclusion: Patients with metabolic syndrome sustaining an isolated ankle fracture are at increased risk for in-hospital complications and a less rapid return of independent functional mobility, as evidenced by the higher need for posthospitalization care. Level of Evidence: Level III, epidemiologic study.