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01-02-2018 | Original Paper

Nutritional markers may identify patients with greater risk of re-admission after geriatric hip fractures

Authors: Austin V. Stone, Alexander Jinnah, Brian J. Wells, Hal Atkinson, Anna N. Miller, Wendell M. Futrell, Kristin Lenoir, Cynthia L. Emory

Published in: International Orthopaedics | Issue 2/2018

Abstract

Purpose

Osteoporotic hip fractures are increasing in prevalence with the growing elderly population. Morbidity and mortality remain high following osteoporotic hip fractures despite advances in medical and surgical treatments. The associated costs and medical burdens are increased with a re-admission following hip fracture treatment. This study sought to identify demographic and clinical values that may be a predictive model for 30-day re-admission risk following operative management of an isolated hip fracture.

Methods

Between January 1, 2013 and April 30, 2015 all patients admitted to a single academic medical centre for treatment of a hip fracture were reviewed. Candidate variables included standard demographics, common laboratory values, and markers of comorbid conditions and nutrition status. A 30-day, all-cause re-admission model was created utilizing multivariate logistic regression.

Results

A total of 607 patients with hip fractures were identified and met the inclusion criteria; of those patients, 67 were re-admitted within 30 days. Univariate analysis indicates that the re-admission group had more comorbidities (p < 0.001) and lower albumin (p = 0.038) and prealbumin (p < 0.001). The final, reduced model contained 12 variables and incorporated four out of five nutritional makers with an internally, cross-validated C-statistic of 0.811 (95% CI: 0.754, 0.867).

Conclusion

Our results indicate that specific nutritional laboratory markers at the index admission may identify patients that have a greater risk of re-admission after hip fracture. This model identifies potentially modifiable risk factors and may allow orthogeriatricians to better educate patients and better treat post-operative nutritional status and care.

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Title: Nutritional markers may identify patients with greater risk of re-admission after geriatric hip fractures
Authors: Austin V. Stone
Alexander Jinnah
Brian J. Wells
Hal Atkinson
Anna N. Miller
Wendell M. Futrell
Kristin Lenoir
Cynthia L. Emory
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 2/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3663-3

At a glance: The STEP trials

Springer Medicine

Nutritional markers may identify patients with greater risk of re-admission after geriatric hip fractures

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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