Incidence, Causes, and Risk Factors of Unplanned Readmissions in Elderly Patients Undergoing Hip Fracture Surgery: An Observational Study

Abstract

Aim The purpose of this study was to examine the incidence and cause of unplanned readmission after Surgically Treated Hip Fractures in Elderly Patients and identify the associated risk factors. Methods This study retrospectively collected the data on elderly patients who underwent hip fracture surgery at two institutions from January 2020 to December 2021, and identified those who were readmitted within 12 months postoperatively. Based on the presence or not of postoperative readmission, they were divided into readmission and non-readmission groups. Demographics, surgery-related variables, and laboratory parameters were compared between groups. The specific causes for documented readmission were collected and summarized. Multivariate logistic regression analysis was performed to identify the associated risk factors. Results There were 930 patients including 76 (8.2%) patients who were readmitted within 12 months postoperatively. Overall, cardiac and respiratory complications and new-onset fractures were the first three common causes of readmission, taking an overwhelming proportion of 53.9% (41/76). Over 60% (61.8%, 47/76) of readmissions occurred within 30 days after surgery, with medical complications taking a predominance (89.4%, 42/47). New-onset fractures accounted for a proportion of 18.4% (14/76), occurring at different time points; especially, at 90–365 days, it accounted for 44.4% (8/18). Multivariate analysis revealed that age ≥80 years (OR, 1.0, 95% CI, 1.0 to 1.1; P=0.032), preoperative albumin level ≤21.5 g/L (OR, 1.1, 95% CI, 1.0 to 1.2; P=0.009), the postoperative occurrence of DVT (OR, 4.2, 95% CI, 2.5 to 7.2; P=0.001), and local anesthesia (OR, 2.1, 95% CI, 1.1 to 4.0; P=0.029) were independent risk factors for unplanned readmissions. Conclusion This study identified several risk factors for unplanned readmissions after elderly hip fractures, and provided detailed information about unplanned readmissions.

Association between admission albumin levels and 30-day readmission after hip fracture surgery in geriatric patients: a propensity score-matched study

“…The 30-day readmission rate of 14.6% found in this elderly hip fracture cohort aligns with readmission rates reported in other studies, which range from 4–30% [ 18 – 20 ]. In a retrospective cohort study of 5637 patients after geriatric hip fractures by Matt et al found hypoalbuminemia was independently associated with a significant increase in readmission risk (11.4% vs. 4.1%; RR 2.53) [ 24 ].…”

“…Tian et al. analyzed 930 patients with hip fracture and discovered that low preoperative albumin levels were predictors of readmission ( p < 0.05) in those patients [ 20 ]. Sim et al.…”

“…30-day readmission after hip fracture surgery is a common phenomenon (4–30%), especially among elderly patients [ 18 – 20 ]. The rate of 30-day readmission has significant implications for the utilization of healthcare resources and the process of patient recovery [ 21 ].…”

D-dimer-albumin ratio (DAR) as a new biomarker for predicting preoperative deep vein thrombosis after geriatric hip fracture patients

“…Further, Chang et al documented the predictive significance of preoperative D-dimer levels for venous thrombosis among lower limb fracture patients [ 45 ]. Additionally, from the analysis of 930 elderly hip fracture patients, Tian et al reported that preoperative low albumin levels were significantly linked with poor prognosis and heightened risk of hospital readmissions [ 55 ]. Interestingly, Panteli et al unveiled that hip fracture patients with hypoalbuminemia during admission significantly experienced an increased mortality risk [ 35 ].…”