BACKGROUND: in older patients, there is a high risk of hospital readmission within the first year after surgery for hip fracture, due to complications following treatment or to the evolution of prior comorbid conditions. OBJECTIVES: to identify factors associated with readmissions related to the index surgical stay. DESIGN: retrospective cohort study. SETTING: administrative claims databases. SUBJECTS: patients over 75 surgically treated for hip fracture in Paris area. METHODS: we analysed all admissions in 2005, and tracked for 1-year readmissions. First readmissions (FRs) were classified as related or unrelated to the index stay, according to rules defined a priori. We analysed the association between patient characteristics and the FR. RESULTS: among 5,709 patients, 32% had at least one readmission, 53% were FR related. Near 80% of related readmissions occurred within 3 months from discharge. Surgical conditions caused 47% of all related readmissions, and male gender, dementia, cancer or kidney diseases were independent risks factors. CONCLUSIONS: half of readmissions could be classified as related to the index stay and a great majority of these occurred early post discharge. Surgical conditions caused 47% of all related readmissions. Improvement in orthopedic-geriatric co-care is suitable to expect an impact on outcomes after surgery.
BACKGROUND: in older patients, there is a high risk of hospital readmission within the first year after surgery for hip fracture, due to complications following treatment or to the evolution of prior comorbid conditions. OBJECTIVES: to identify factors associated with readmissions related to the index surgical stay. DESIGN: retrospective cohort study. SETTING: administrative claims databases. SUBJECTS:patients over 75 surgically treated for hip fracture in Paris area. METHODS: we analysed all admissions in 2005, and tracked for 1-year readmissions. First readmissions (FRs) were classified as related or unrelated to the index stay, according to rules defined a priori. We analysed the association between patient characteristics and the FR. RESULTS: among 5,709 patients, 32% had at least one readmission, 53% were FR related. Near 80% of related readmissions occurred within 3 months from discharge. Surgical conditions caused 47% of all related readmissions, and male gender, dementia, cancer or kidney diseases were independent risks factors. CONCLUSIONS: half of readmissions could be classified as related to the index stay and a great majority of these occurred early post discharge. Surgical conditions caused 47% of all related readmissions. Improvement in orthopedic-geriatric co-care is suitable to expect an impact on outcomes after surgery.
Authors: Katie J Sheehan; Boris Sobolev; Pierre Guy; Eric Bohm; Erik Hellsten; Jason M Sutherland; Lisa Kuramoto; Susan Jaglal Journal: J Orthop Res Date: 2015-08-11 Impact factor: 3.494
Authors: Fátima de Lima Paula; Geraldo Marcelo da Cunha; Iúri da Costa Leite; Rejane Sobrino Pinheiro; Joaquim Gonçalves Valente Journal: Rev Saude Publica Date: 2016-05-03 Impact factor: 2.106