Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture

KONYA, Mehmet Nuri; SOFU, Hakan; ŞAHİN, Vedat; ÇAMURCU, İsmet Yalkın; GÜRSU, ŞÜKRÜ SARPER; ÜÇPUNAR, Hanifi; duman, serda

Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture

Hakan SOFU, (Department of Orthopedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan-Turkey)

Hanifi ÜÇPUNAR, (Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Training and Research Hospital, İstanbul-Turkey)

İsmet Yalkın ÇAMURCU, (Department of Orthopedics and Traumatology, Devrek State Hospital, Zonguldak-Turkey)

Serda DUMAN, (Department of Orthopedics and Traumatology, Diyarbakır Selahaddin Eyyübi State Hospital, Diyarbakır-Turkey)

Mehmet Nuri KONYA, (Department of Orthopedics and Traumatology, Afyon Kocatepe University Faculty of Medicine, Afyon-Turkey)

ŞÜKRÜ SARPER GÜRSU, (Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Training and Research Hospital, İstanbul-Turkey)

Vedat ŞAHİN (Department of Orthopedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan-Turkey)

Ulusal Travma ve Acil Cerrahi Dergisi

0 0

Yıl: 2017 Cilt: 23 Sayı: 3 Sayfa Aralığı: 245 - 250 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture

Öz:

BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated. The rate of early readmission, age, gender, body mass index, fracture type, pre-fracture mobility status, preoperative time to surgery, American Society of Anesthesiologists score, implant type, postoperative intensive care unit stay, total length of postoperative hospital stay, comorbidities, and the main reasons for readmission were the criteria for data collection. Multivariate analysis was performed to determine the main predictors of early hospital readmission. Mortality within the first year after surgery was also assessed.RESULTS: A higher prevalence of chronic obstructive pulmonary disease, cardiac arrhythmia or ischemic heart disease, diabetes, and dementia or Parkinson’s disease was detected in readmitted patients. Advanced age, American Society of Anesthesiologists (ASA) grade ≥3, postoperative intensive care unit (ICU) stay, and pre-existing cardiac arrhythmia or ischemic heart disease were identified as the main predictors. The 1-year mortality rate for the readmitted group was 53.9%, whereas it was 24% for those patients who were not readmitted.CONCLUSION: The readmission rate following surgical treatment of hip fracture in elder patients was 12%, and its main predictive factors were advanced age, ASA grade ≥3, postoperative ICU stay, and pre-existing cardiac arrhythmia or ischemic heart disease. Hospital readmission within the first 30-day period following initial discharge was significantly correlated with an increased 1-year mortality rate

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Vergara I, Vrotsou K, Orive M, Gonzalez N, Garcia S, Quintana JM. Factors related to functional prognosis in elderly patients after accidental hip fractures: a prospective cohort study. BMC Geriatr 2014;14:124.
2. Baumgaertner MR, Higgins TF. Femoral neck fractures. In: Bucholz RW, Heckman JD, Rockwood CA, Green DP, editors. Rockwood and Green’s Fractures in adults. Philadelphia: Lippincott Williams & Wilkins; 2002. pp. 1579.
3. Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuori I, Järvinen M. Epidemiology of hip fractures. Bone 1996;18:57–63.
4. Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285–9.
5. Pollock FH, Bethea A, Samanta D, Modak A, Maurer JP, Chumbe JT. Readmission within 30 days of discharge after hip fracture care. Orthopedics 2015;38:7–13.
6. Khan MA, Hossain FS, Dashti Z, Muthukumar N. Causes and predictors of early re-admission after surgery for a fracture of the hip. J Bone Joint Surg Br 2012;94:690–7.
7. Orces CH. In-hospital hip fracture mortality trends in older adults: the National Hospital Discharge Survey, 1988-2007. J Am Geriatr Soc 2013;61:2248–9.
8. Frost SA, Nguyen ND, Black DA, Eisman JA, Nguyen TV. Risk factors for in-hospital post-hip fracture mortality. Bone 2011;49:553–8.
9. Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 2009;20:1633–50.
10. Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P, et al. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord. 2011;12:105.
11. Halm EA, Magaziner J, Hannan EL, Wang JJ, Silberzweig SB, Boockvar K, et al. Frequency and impact of active clinical issues and new impairments on hospital discharge in patients with hip fracture. Arch Intern Med 2003;163:108–13.
12. Härstedt M, Rogmark C, Sutton R, Melander O, Fedorowski A. Impact of comorbidity on 6-month hospital readmission and mortality after hip fracture surgery. Injury 2015;46:713–8.
13. Garcia AE, Bonnaig JV, Yoneda ZT, Richards JE, Ehrenfeld JM, Obremskey WT, et al. Patient variables which may predict length of stay and hospital costs in elderly patients with hip fracture. J Orthop Trauma 2012;26:620–3.
14. Dailey EA, Cizik A, Kasten J, Chapman JR, Lee MJ. Risk factors for readmission of orthopaedic surgical patients. J Bone Joint Surg Am 2013;95:1012–9.
15. French DD, Bass E, Bradham DD, Campbell RR, Rubenstein LZ. Rehospitalization after hip fracture: predictors and prognosis from a national veterans study. J Am Geriatr Soc 2008;56:705–10.
16. Boockvar KS, Halm EA, Litke A, Silberzweig SB, McLaughlin M, Penrod JD, et al. Hospital readmissions after hospital discharge for hip fracture: surgical and nonsurgical causes and effect on outcomes. J Am Geriatr Soc 2003;51:399–403.
17. Buecking B, Eschbach D, Koutras C, Kratz T, Balzer-Geldsetzer M, Dodel R, et al. Re-admission to Level 2 unit after hip-fracture surgery - Risk factors, reasons and outcome. Injury 2013;44:1919–25.
18. Riggs RV, Roberts PS, Aronow H, Younan T. Joint replacement and hip fracture readmission rates: impact of discharge destination. PM R 2010;2:806–10.
19. Eschbach DA, Oberkircher L, Bliemel C, Mohr J, Ruchholtz S, Buecking B. Increased age is not associated with higher incidence of complications, longer stay in acute care hospital and in hospital mortality in geriatric hip fracture patients. Maturitas 2013;74:185–9.
20. Hahnel J, Burdekin H, Anand S. Re-admissions following hip fracture surgery. Ann R Coll Surg Engl 2009;91:591–5.
21. Golinvaux NS, Bohl DD, Basques BA, Baumgaertner MR, Grauer JN. Diabetes confers little to no increased risk of postoperative complications after hip fracture surgery in geriatric patients. Clin Orthop Relat Res 2015;473:1043–51.
22. Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 2005;331:1374.

APA	SOFU H, ÜÇPUNAR H, ÇAMURCU İ, duman s, KONYA M, GÜRSU Ş, ŞAHİN V (2017). Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. , 245 - 250.
Chicago	SOFU Hakan,ÜÇPUNAR Hanifi,ÇAMURCU İsmet Yalkın,duman serda,KONYA Mehmet Nuri,GÜRSU ŞÜKRÜ SARPER,ŞAHİN Vedat Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. (2017): 245 - 250.
MLA	SOFU Hakan,ÜÇPUNAR Hanifi,ÇAMURCU İsmet Yalkın,duman serda,KONYA Mehmet Nuri,GÜRSU ŞÜKRÜ SARPER,ŞAHİN Vedat Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. , 2017, ss.245 - 250.
AMA	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. . 2017; 245 - 250.
Vancouver	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. . 2017; 245 - 250.
IEEE	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V "Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture." , ss.245 - 250, 2017.
ISNAD	SOFU, Hakan vd. "Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture". (2017), 245-250.

APA	SOFU H, ÜÇPUNAR H, ÇAMURCU İ, duman s, KONYA M, GÜRSU Ş, ŞAHİN V (2017). Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi, 23(3), 245 - 250.
Chicago	SOFU Hakan,ÜÇPUNAR Hanifi,ÇAMURCU İsmet Yalkın,duman serda,KONYA Mehmet Nuri,GÜRSU ŞÜKRÜ SARPER,ŞAHİN Vedat Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi 23, no.3 (2017): 245 - 250.
MLA	SOFU Hakan,ÜÇPUNAR Hanifi,ÇAMURCU İsmet Yalkın,duman serda,KONYA Mehmet Nuri,GÜRSU ŞÜKRÜ SARPER,ŞAHİN Vedat Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi, vol.23, no.3, 2017, ss.245 - 250.
AMA	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi. 2017; 23(3): 245 - 250.
Vancouver	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi. 2017; 23(3): 245 - 250.
IEEE	SOFU H,ÜÇPUNAR H,ÇAMURCU İ,duman s,KONYA M,GÜRSU Ş,ŞAHİN V "Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture." Ulusal Travma ve Acil Cerrahi Dergisi, 23, ss.245 - 250, 2017.
ISNAD	SOFU, Hakan vd. "Predictive factors for early hospital readmission and 1-year mortality in elder patients following surgical treatment of a hip fracture". Ulusal Travma ve Acil Cerrahi Dergisi 23/3 (2017), 245-250.