TITLE:
Incidence and Predictors of Complications of Acute Achilles Tendon Rupture Repair at Hamad General Hospital, Doha, Qatar
AUTHORS:
Sameh M. Abolfotouh, Mohamed A. Al Dosari, Nader Sayed, Hussam Banna, Mostafa A. Abolfotouh
KEYWORDS:
Achilles Tendon; Repair; Surgical; Outcome; HGH; Qatar
JOURNAL NAME:
Surgical Science,
Vol.5 No.2,
February
7,
2014
ABSTRACT:
Aim: The aims of this
study were: 1) to estimate the prevalence and pattern of complications after
Achilles tendon (AT) repair, and 2) to determine the
significant predictors of post-operative infection. Methods: A retrospective
cohort study of all patients who were operated at Hamad General Hospital (HGH) between June
2010 and June 2012 for AT rupture (n = 102), was
conducted. Data was collected on 1) patient’ characteristics such as age, sex; 2) disease
characteristics such as mechanism of rupture, type of rupture (partial
or complete), whether an anterior or posterior slab was applied, number of
suture materials, number of antibiotics, surgical time, time to surgery and
length of hospital stay (LOS), number of follow up visits, and 3)
complications. Descriptive and analytical statistical analyses were applied.
Receiver operating characteristic curve was applied to identify the validity of
different LOS values, with a significance level at p ≤ 0.05.
Results: Of the 102 patients with Achilles rupture, almost males (96.1%), with
a mean age 31.07 ± 9.71 years, 52% with complete rupture, the
majority were open ruptures (81.4%) and bathroom-related (70.6%). Anterior slab
was applied to 58.2% and 2 types of suture materials to 71.6% of cases. Fifteen
cases (14.7%, 95% CI: 7.8% - 21.6%)
presented with one or more complications (9.8% post-operative infections, 5.9%
stiffness and 2% re-rupture). Post-operative infections were
significantly associated with: old age (z = 2.11, p = 0.035),
longer LOS (z = 2.01, p = 0.04),
and presence of diabetes (Fisher exact test: p = 0.003).
After adjustment for age, LOS (p = 0.04)
and diabetes (p = 0.017) remained as
significant predictors of post-operative infections. LOS of 2.5 days was the
optimum cut-off point above which post-operative infection is more likely to
occur, with sensitivity of 80% and specificity of 54%. Conclusion: Achilles
repair post operative infection ranks first as a complication of AT surgical
repair, and its incidence is relatively higher in HGH than the counterpart
figures in the literature. The presences