Hospital readmission after hip fracture

Abstract

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 \ 0.0001). Independent predictors of readmission were age [85 (OR = 1.52; p = 0.03), time to surgery [24 h (OR = 1.50; p = 0.05), Charlson score C4 (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.

Factors associated with the successful removal of indwelling urinary catheters post-operatively in the fragility hip fracture patient

“…This may reflect a poor bowel habit pre fracture and should be addressed on admission with an aggressive bowel regime in this cohort of patients. As discussed by Kates et al (2015) better attention to bowel regimes may reduce readmission following hip fracture surgery. There is controversy surrounding the length of catheterisation time and its relationship with successful IDC removal.…”

Hip Fracture in the Elderly

“…Nevertheless, physicians should be aware that complications can occur and that 6 Clinical Medicine Insights: Geriatrics readmissions are frequent, which can generate enormous expenses. 104,105 However, the correct and prompt management of complications reduces their adverse effect on patients' outcomes.…”

Meðferð og afdrif sjúklinga með mjaðmarbrot

“…Erlendis er þetta hlutfall um 12% en þar er miðað við endurinnlögn innan 30 daga. 33 Í þessari rannsókn voru öll tilfelli endurinnlagna höfð með sem var haegt að rekja til fylgikvilla mjaðmarbrotsins, óháð tíma.…”