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Higher ASA class, BMI associated with decreased physical function after ankle surgery

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TORONTO — Increased American Society of Anesthesiologists class, BMI and patient age at the time of surgery for ankle fracture were independently predictive of decreased physical function, while increased pain was associated with lower BMI and higher American Society of Anesthesiologists class, according to results presented here.

“Conclusions of our study are that higher age, an ASA class greater than or equal to 2 and higher BMI are associated with decreased physical function more than 2 years postoperatively from an ankle fracture fixation, and lower BMI and an increased ASA class greater than or equal to 2 are associated with increased pain,” Daniel M. Dean, MD, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.

Daniel M. Dean

Using a multicenter cohort, Dean and colleagues studied 142 patients who underwent surgery for ankle fracture between 2001 and 2013. Patients had a minimum of 2 years of follow-up and completed a patient-reported outcomes measurement system test. Patients had an average age of 52.7 years and an average follow-up of 6.2 years, according to researchers. Results showed a mean physical function score of 51.9 and a mean pain interference score of 47.8.

“On univariate analysis, we found that no injury characteristics were associated with differences in physical function or pain interference scores,” Dean said.

However, he noted decreased physical function was associated with female sex, increased age, the presence of diabetes and increasing BMI and American Society of Anesthesiologists (ASA) class. Multivariate regression analysis showed decreased physical function was associated with increased age, BMI and ASA class.

According to results, a lower BMI and an increasing ASA class were associated with increased pain. ASA class had a much larger magnitude of effect than other variables for both decreased physical function and increased pain, Dean noted. – by Casey Tingle

Reference:

Dean DM, et al. Predictors of long-term functional outcome in operative ankle fractures. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 21-23, 2016; Toronto.

Disclosure: Dean reports no relevant financial disclosures.