Replantation-Adverse Events Following Digital Replantation in the Elderly

Adverse Events Following Digital Replantation in the Elderly

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The purpose of this study was to compare adverse events in patients less than 65 years of age compared with those 65 years and older after digital replantation. The study found that there was no difference in sentinel perioperative complications or mortality when comparing replantation patients under 65 years of age and those age 65 and older. Age alone should not be considered an absolute contraindication to finger replantation. Instead, the patient’s functional demands, type of injury, general state of health, and rehabilitative potential should be considered when deciding whether to proceed with replantation. The study analyzed data from the Nationwide Inpatient Sample over a 10-year period from 1998 to 2007. They identified replantation procedures using International Classification of Diseases–9 procedure codes for finger and thumb reattachment. Adverse events were identified using Patient Safety Indicators. The overall in-hospital mortality was 0.04% and there was no statistical difference when factoring in age. The study found that the most common adverse events were postoperative deep venous thrombosis and pulmonary embolism. There was no difference in adverse events between the two age groups, but the older group had a higher rate of transfusion and were more likely to have a non-routine disposition, such as going to a nursing home. The study concluded that age should not be considered a contraindication to finger replantation and that other factors should be considered when making the decision to proceed with surgery.

Keywords

adverse events

digital replantation

age comparison

mortality

finger replantation

functional demands

rehabilitative potential

Nationwide Inpatient Sample

in-hospital mortality

surgery decision