One-Year Readmission Risk and Mortality after Hip Fracture Surgery: A National Population-Based Study in Taiwan

Abstract

Early readmission following hip fracture (HFx) is associated with high morbidity and mortality. We conducted a survival analysis of patients with readmission within 1 year after HFx to elucidate the trend and predictors for readmission. We used Taiwan National Health Insurance Database to recruit HFx patients who underwent operations between 2000 and 2009. Patients < 60 years; with pathological fractures; involved in major traffic accidents; with previous pelvis, femur, and hip operations; or who died during the index admission were excluded. We used the Chi-square test, logistic regression, Kaplan-Meier method, and Cox proportional hazards model to analyze variables, including age, gender, hospital stay duration, index admission time, and comorbidity on readmission. 5,442 subjects (61.2% female) met the criteria with mean age of 78.8 years. Approximately 15% and 43% HFx patients were readmitted within 30 days (early) and between 30 days and 1 year (late) after discharge, respectively. Highest readmission incidence was observed within the first 30 days. Most common causes of readmission in early and late groups were respiratory system diseases and injuries, respectively. Cox model showed male, old age, hospital stay > 9 days, Charlson Comorbidity Index ≥ 1, index admission during 2000–2003, and internal fixation of HFx were independent predictors of readmission. One-year mortality of the early and the late readmission groups was 44.9% and 32.3%, much higher than overall mortality which was 16.8%. Predictive factors for readmission within 1 year included male, old age, comorbidities, and longer hospital stay. One-year mortality in readmitted patients was significantly higher. HFx patients with these factors need careful follow-up, especially within 30 days after discharge.

One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study

“…They have been associated with increased morbidity, loss of autonomy in Activities of Daily Living (ADLs), high rate of institutionalization and mortality 4,5 . The mortality in the first year after hip fractures surgery is high, ranging between 15% and 36% 4,6–9 . Dubljanin-Raspopovic et al .…”

Prevalence of Factors That Can Increase the Risk of Hip Fracture and Its Complications after Surgery

“…Another study conducted by Lee et al (31) and concerned with one-year readmission risk and mortality after hip fracture surgery concluded that, In this population-based study of 5442 patients who underwent surgical treatment of hip fractures, we found the predictive factors for readmission included male gender, older age, a higher number of comorbidities, and a longer hospital stay in both early and late readmission groups. A higher risk of readmission is observed during the first 30 days of follow-up.…”

Association of early vertebroplasty with risk of hip replacement

“…In 2011, 10.7% of the entire population was ≥ 65 years old; this figure is more than 14% in 2017. [ 4 ] Some authors concluded that a relationship between vertebral deformities and hip fracture that vertebral deformities have in prospective studies been reported as a risk factor for a future hip fracture. [ 5 – 8 ]…”