The Impact of HBA1C and Complicated Diabetes on Operative and Non-operative Ankle Fracture Outcomes

Description

In this presentation, Sean Scattergood discusses his study on the impact of complicated diabetes and HbA1c levels on the outcomes of ankle fractures in both surgical and non-surgical management settings. The study is based on data from the BRI in Bristol, addressing a crucial public health issue as diabetes is increasingly prevalent in the UK, with an estimated 4 million cases. Sean highlights the significant increase in fracture risk among diabetic patients, particularly lower limb fractures, and notes the challenges associated with surgical recovery in these individuals.



The research involved a retrospective cohort study examining adult ankle fractures diagnosed between January 2016 and January 2019, with patient data meticulously gathered from various medical records. The study aimed to compare diabetic and non-diabetic cohorts, revealing a notable trend toward longer hospital stays and increased complication rates in diabetic patients. Notably, 59% of diabetic patients had poorly controlled diabetes, indicated by elevated HbA1c levels over 69 mmol/mol. The results suggested that diabetics experienced higher rates of postoperative complications, particularly wound infections, compared to their non-diabetic counterparts.



Sean elaborates on the findings, indicating that as HbA1c levels rise above 69, the risks of surgical complications also increase significantly. This information is imperative for developing management strategies and informing patients about their heightened risk for complications and longer follow-up periods. The presentation concludes with a question-and-answer segment addressing concerns about differences in operative complications between type 1 and type 2 diabetes and the appropriateness of the HbA1c cutoff used in the study.

DOI: 10.1302/3114-221061

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