Operative care rates of lateral compression type 1 pelvic fractures increased from 2003 to 2018

PURPOSE: To investigate trends in operative management of LC1 pelvic fractures and potential effects on hospital length of stay, home discharge, and mortality. METHODS: The National Inpatient Sample (NIS) was queried and identified 43,743 older adults aged ≥ 60 years and 29,024 younger adults aged 18-59 years who had LC1 fractures via ICD diagnosis codes (2003-2018). Operative management was classified by ICD procedure codes for internal and/or external fixation. Adjusted annual change in rate of operative care, length of stay, mortality, and home discharge were assessed using multivariable robust Poisson regression models. RESULTS: Operative care was provided to 1413 (3.2%) older adults and 5871 (20.2%) younger adults. Among older adults, operative care increased 5% per year (RR per year: 1.05, 95% CI 1.03-1.06, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), home discharge (RR per year: 0.99, 95% CI 0.99-1.00, p = 0.02) and mortality (RR per year: 0.95, 95% CI 0.95-0.96, p < 0.001). Among younger adults, operative care increased 2% per year (RR per year: 1.02, 95% CI 1.01-1.02, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), and mortality (RR per year: 0.95, 95% CI 0.94-0.96, p < 0.001). CONCLUSION: Operative care of LC1 fractures in the United States increased from 2003 to 2018. A rise in operative care was associated with decreases in length of stay and mortality in older and younger adults, but fewer home discharges for older adults. LEVEL OF EVIDENCE: Level III Therapeutic.