Introduction:
Ankle fracture is the third most common fracture with a seasonal-occurrence variation in the Nordic countries. Ankle fractures commonly require surgery and anaesthesia. An important quality-indicator of perioperative-care is the all-cause 30-day mortality. Little is known about early mortality after ankle fracture repair in Sweden and whether there is a seasonal-occurrence variation of the 30-day mortality.
Aim
The aim of the present register-based study was to assess seasonal-variation in all-cause 30-day mortality associated with surgical repair of ankle fractures in Sweden during a 10-year period; 2012–2022 adjusted for age and ASA-class.
Material and Methods
All patients aged ≥ 18 years who underwent ankle fracture surgery and were registered in the Swedish Perioperative Quality Register (SPOR) between 2012 and 2022, with seasonal information, were included in the analysis (n = 31,655). Information on patient characteristics, perioperative observations, and early mortality were collected. Descriptive and regression statistics were applied.
Results
The all-cause 30-day mortality was 0.24%, with significantly lower 30-day mortality during summer (0.09%) compared with autumn (0.32%) and spring (0.28%), (p = 0.026). Patients undergoing ankle fracture surgery were significantly younger and had a significantly higher proportion of low-risk ASA-class during the summer period. The odds ratio of dying within 30-days were still significantly lower during the summer compared with the other seasons, both unadjusted and adjusted for age-, ASA-class, gender, and urgency of procedure. Increased risk for mortality within 30-days was seen among elderly, females, high ASA-class, and emergent surgery.
Conclusions
The all-cause 30-day mortality rate after ankle fracture surgery in Sweden is reassuringly low, with the lowest rate seen during the summer. Advancing age and higher ASA-class were associated with an increasing risk of 30-day mortality.