Operative Versus Nonoperative Management of Pyogenic Flexor Tenosynovitis: An Analysis of the National Readmissions Database

Abstract

PurposeThe purpose of this study was to use a national database to determine if either operative or non-operative management of pyogenic flexor tenosynovitis (PFT) led to specific superior outcomes. Materials and MethodsICD-10 codes were used to identify patients admitted with PFT from the National Readmissions Database (NRD) for the years 2016-2019. All patients had been admitted initially and treated with either operative or nonoperative management. Baseline characteristics were determined, and in those who were readmitted, the top ten diagnoses of 90-day readmissions were identified. Risk factors for readmission were identified using a regression analysis. 90-day readmission rate, amputation rate, and length of stay between the groups were compared as these are outcomes that can be reviewed from the database. ResultsThe overall 90-day readmissions rate was 13.25%. Infectious complications from the original diagnosis of PFT were the leading causes of readmission. Variables associated with 90-day readmission were higher Charlson Comorbidity Index, hypertension, Medicaid insurance, longer initial length of hospital stay, tobacco use, and non-operative management. 90-day readmission rate and amputation rate were higher in the nonoperative group. ConclusionsIn patients with PFT, operative intervention may prevent hospital readmissions and reduce the likelihood of amputation. Readmission is more likely in patients with more medical comorbidities, tobacco users, and lower socioeconomic status.