The Effect of Patient Age on the Success Rate of Digital Replantation.

BACKGROUND: The purpose of this study was to evaluate outcomes and risk factors for failure after digital replantation in elderly patients, with a special focus on the effect of patient age on replantation success.

METHODS: Replantation patients older than 60 years were analyzed thoroughly to characterize outcomes and risk factors for failure in older patients. Survival rates of all age groups older than 20 years were then analyzed to determine the specific effect of patient age on replantation success. The clinical and functional outcomes and risk factors for failure were evaluated at a minimum 1-year follow-up.

RESULTS: Among 161 patients older than 60 years, 189 of 208 replanted digits survived completely (91 percent survival). The only factors predictive of failure were mechanism of injury and age. Excellent or good results (Chen criteria) were obtained in 58 percent of patients, and 94 percent of patients were completely or fairly satisfied. Analysis of all age groups older than 20 (1648 patients) demonstrated a significant increase in failure rate in those aged 70 years and older.

CONCLUSIONS: The authors demonstrated a high rate of digit replantation success in elderly patients. However, 70 years and older was identified as an important factor predicting replantation failure.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.