Hospital readmission after hip fracture
Introduction Readmission to the hospital following a hip fracture is common, often involves an adverse event, and strains an already overburdened health care system. Objectives To assess the rate of 30-day readmission to the hospital after discharge for care of hip fracture. A secondary objective wa...
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Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2015-03, Vol.135 (3), p.329-337 |
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Sprache: | eng |
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Zusammenfassung: | Introduction
Readmission to the hospital following a hip fracture is common, often involves an adverse event, and strains an already overburdened health care system.
Objectives
To assess the rate of 30-day readmission to the hospital after discharge for care of hip fracture. A secondary objective was measurement of the 30-day mortality rate for those patients readmitted versus those patients not readmitted to the hospital after discharge.
Materials and methods
Study design was a retrospective review of registry data comparing readmitted patients to those not readmitted after hip fracture. Setting was a university affiliated level 3 trauma center. Participants: 1,081 patients aged 65 and older. Measurements: rate of readmission, rate of mortality, predictors of readmission.
Results
129 patients (11.9 %) were readmitted to the hospital within 30 days of their initial discharge date. The primary causes of readmission were surgical in nature for 24/129 (18.6 %) patients and 105/129 (81.4 %) were readmitted for medical or other reasons. Twenty-four (18.6 %) patients who were readmitted died during readmission. The one-year mortality rate for patients readmitted within 30 days was 56.2 vs. a 21.8 % 1-year mortality rate for those patients not readmitted (
p
85 (OR = 1.52;
p
= 0.03), time to surgery >24 h (OR = 1.50;
p
= 0.05), Charlson score ≥4 (OR = 1.70;
p
= 0.04), delirium (OR = 1.65;
p
= 0.01), dementia (OR = 1.61;
p
= 0.01), history of arrhythmia with pacemaker placement (OR = 1.75;
p
= 0.02), and presence of a pre-op arrhythmia (OR = 1.62;
p
= 0.02).
Conclusion
Readmission after hip fracture is harmful and undesirable—18.6 % of readmitted patients died during their readmission and the average length of stay was 8.7 days. Approximately one of every six readmissions was identified as potentially preventable with interventions. |
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ISSN: | 0936-8051 1434-3916 |
DOI: | 10.1007/s00402-014-2141-2 |