Surgical Science, 2014, 5, 46-52 Published Online February 2014 (http://www.scirp.org/journal/ss ) http://dx.doi.org/10.4236/ss.2014.52011 OPEN ACCESS SS Incidence and Predictors of Complications of Acute Achilles Tendon Rupture Repair at Hamad General Hospital, Doha, Qatar Sameh M. Abolfotouh 1 , Mohamed A. Al Dosari 1 , Nader Sayed 1 , Hussam Banna 1 , Mostafa A. Abolfotouh 2 1 Hamad General Hospital, Doha, Qatar 2 King Abdullah International Medical Research Center, Riyadh, KSA Email: mabolfotouh@gmail.com Received December 15, 2013; revised January 10, 2014; accepted January 18, 2014 Copyright © 2014 Sameh M. Abolfotouh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights © 2014 are reserved for SCIRP and the owner of the intellectual property Sameh M. Abolfotouh et al. All Copyright © 2014 are guarded by law and by SCIRP as a guardian. ABSTRACT Aim: The aims of this study were: 1) to estimate the prevalence and pattern of complications after Achilles ten- don (AT) repair, and 2) to determine the significant predictors of post-operative infection. Methods: A retros- pective 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 dia- betes (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 of diabetes and LOS are independent predictors of this infection. Further prospective studies are recommended to control for all possible confounders of outcome of AT rupture repair. KEYWORDS Achilles Tendon; Repair; Surgical; Outcome; HGH; Qatar 1. Introduction The Achilles Tendon (AT) is one of the most frequently ruptured tendons in the human body [1] and has become the third most frequent major tendon injury behind those of the rotator cuff and knee-extensor mechanisms [2]. There has been an increase in incidence over the last half century [3], with studies reporting up to 18 per 100,000 [1]. Acute ruptures of the Achilles tendon most common- ly affect individuals in their third to fifth decade of life who are intermittently active [4]. The etiology of Acute Achilles tendon ruptures is multi-factorial and includes overuse injuries, host factors, medications, or inappro-