Comparison of lengths of hospital stay after surgery and mortality in elderly hip fracture patients between Japan and the United States – the relationship between the lengths of hospital stay after surgery and mortality

Abstract

Shorter lengths of stay after surgery did not predict better survival across the two countries. Larger longitudinal or randomized studies that determine the effects of LOS after surgery on mortality are necessary.

Nursing Care after Hip Fracture Surgery Predicts Patient Ambulatory Ability at 3 Months after Surgery

“…Getting out of bed accelerates blood circulation and respiratory functions, which contribute to preventing complications or to recovering from complications. The timing for getting out of bed was later in Japanese hospitals than in US hospitals, although the incidence of complications was lower compared to US hospitals (2.5 days vs. 1.6 days after surgery) [7]. In this study, the timing for getting out of bed was earlier than that in the Japanese hospitals in the previous study, but it was still later when compared to that in the US hospitals.…”

“…Reducing the LOS, however, may degrade hip fracture patients' outcomes at discharge as fewer patients are being discharged to their homes and fewer patients are able to walk independently at discharge [6]. Too short a LOS in acute care may even increase the mortality for hip fracture patients after discharge, as indicated by a comparison of the data for Japan and the US [7].…”

“…Early getting out of bed after surgery was associated with a decreased risk of mortality [7,11]. In addition, an early initial date of weight bearing after surgery predicts a higher ambulatory ability at 3 months after surgery [12].…”

Total length of stay, costs and outcomes at final discharge for admitted patients with hip fracture: linked episode data for Australian veterans and war widows

“…9 While reporting total LOS of 17 and 23 days, respectively, both reports ascribe less than half of the total hospital days to acute (surgical) episodes. Systems that report only acute episode data show median values of 5-9 days, 5,10 while systems that incorporate rehabilitation have mean LOS of up to 44 days. 10,11 There are commensurate differences in hospital outcome profiles.…”

“…Systems that report only acute episode data show median values of 5-9 days, 5,10 while systems that incorporate rehabilitation have mean LOS of up to 44 days. 10,11 There are commensurate differences in hospital outcome profiles. 5,[11][12][13] This study will demonstrate, for a large cohort of elderly Australian patients, the very wide differences in LOS, hospital costs and patient outcome profiles between values derived through linkage of all relevant hospital episodes and those based upon unlinked data.…”