Determining the incidence and risk factors for short-term complications following distal biceps tendon repair

Abstract

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Surgical repair has the potential to provide functional improvement for patients. However, early complications following biceps tendon repair are not well described in the literature. This study aims to utilize a verified national surgical database to determine the incidence of and predictors for various short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index (BMI), American Society of Anesthesiologists class, functional status, and several comorbidities were reported for each patient, along with various 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables.Results: Early postoperative overall surgical complications (0.5%)—which were mostly infections (0.4%)—and overall medical complications (0.3%) were rare. A risk factor for readmission was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180–15.218). Risk factors for non-home discharge were smoking (RR, 3.006; 95% CI, 1.123–8.044) and 60 years of age (RR, 4.150; 95% CI, 1.611–10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005–0.126). Risk factors for surgical complications were obese class II (RR, 4.120; 95% CI, 1.123–15.120]), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719–129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266–32.689). An independent functional status was protective against surgical complications (RR, 0.023; 95% CI, 0.002–0.221).Conclusions: Overall complication rates after distal biceps repair are quite low. Patient demographics (sex, age, BMI, and functional status), medical comorbidities (diabetes, smoking, and COPD), and surgical factors (inpatient versus outpatient surgery) were all predictive of various short-term complications.