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Prediction of readmissions in the first post-operative year following hip fracture surgery

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To define risk factors for rehospitalization following fragility hip fractures and to create a predictive model.

Methods

A retrospective cohort study of patients 65 years and older, who were treated operatively following fragility hip fractures between 01.2011 and 06.2016. Patients were allocated into two study groups based on the occurrence of recurrent hospitalizations in the year following surgery. Demographic information, comorbidities, and in-hospital characteristics were collected, as was information regarding 1-year readmissions. Multivariate analysis of factors predictive of rehospitalizations was performed, followed by a logistic regression using all predictors with p < 0.05. A stepwise backwards elimination method was used to create the predictive model.

Results

Eight hundred and fifty-one patients were included; 369 (43.4%) had recurrent hospitalizations within the first post-operative year. Patients who were rehospitalized were more likely to be males, to use a walking aid and to live dependently. They had a higher age-adjusted Charlson’s comorbidity index (ACCI) score, a higher perveance of atrial fibrillation, lower hemoglobin, worse renal function, less platelets, and longer time to surgery. Prevalence of in-hospital complications was similar. Six variables were found to independently influence the chance for readmissions: male gender, the use of a walking aid, higher ACCI score, lower hemoglobin, atrial fibrillation, and a longer surgical delay. Only the first four were found to be adequate predictors and were added to the prediction formula.

Conclusion

High 1-year readmission rates are seen following discharge in patients with fragility hip fractures. Addressing risk factors might aid to better rehabilitate patients and reduce morbidity.

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Authors and Affiliations

  1. Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St., Petah Tikva, 49100, Tel Aviv, Israel

    Tal Frenkel Rutenberg, Maria Vitenberg, Nir Cohen & Steven Velkes

  2. IDF Medical Corps, Tel Aviv, Israel

    Ran Rutenberg

  3. Geriatric Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yichayaou Beloosesky

Authors
  1. Tal Frenkel Rutenberg
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  2. Ran Rutenberg
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  3. Maria Vitenberg
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  4. Nir Cohen
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  5. Yichayaou Beloosesky
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  6. Steven Velkes
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Corresponding author

Correspondence to Tal Frenkel Rutenberg.

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Conflict of interest

Author Tal Frenkel Rutenberg, Author Ran Rutenberg, Author Maria Vitenberg, Author Nir Cohen, Author Yichayaou Beloosesky and Author Steven Velkes declare that they have no conflict of interests.

Ethical standards

The study was approved by the institutional ethics committee in accordance with the Declaration of Helsinki.

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Frenkel Rutenberg, T., Rutenberg, R., Vitenberg, M. et al. Prediction of readmissions in the first post-operative year following hip fracture surgery. Eur J Trauma Emerg Surg 46, 939–946 (2020). https://doi.org/10.1007/s00068-018-0997-5

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  • DOI: https://doi.org/10.1007/s00068-018-0997-5

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