Hospital readmission after hip fracture

Stephen L. Kates, Caleb Behrend, Daniel A. Mendelson, Peter Cram, Susan M. Friedman

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Introduction: Readmission to the hospital following a hip fracture is common, often involves an adverse event, and strains an already overburdened health care system.

Objectives: To assess the rate of 30-day readmission to the hospital after discharge for care of hip fracture. A secondary objective was measurement of the 30-day mortality rate for those patients readmitted versus those patients not readmitted to the hospital after discharge.

Materials and methods: Study design was a retrospective review of registry data comparing readmitted patients to those not readmitted after hip fracture. Setting was a university affiliated level 3 trauma center. Participants: 1,081 patients aged 65 and older. Measurements: rate of readmission, rate of mortality, predictors of readmission.

Results: 129 patients (11.9 %) were readmitted to the hospital within 30 days of their initial discharge date. The primary causes of readmission were surgical in nature for 24/129 (18.6 %) patients and 105/129 (81.4 %) were readmitted for medical or other reasons. Twenty-four (18.6 %) patients who were readmitted died during readmission. The one-year mortality rate for patients readmitted within 30 days was 56.2 vs. a 21.8 % 1-year mortality rate for those patients not readmitted (p < 0.0001). Independent predictors of readmission were age >85 (OR = 1.52; p = 0.03), time to surgery >24 h (OR = 1.50; p = 0.05), Charlson score ≥4 (OR = 1.70; p = 0.04), delirium (OR = 1.65; p = 0.01), dementia (OR = 1.61; p = 0.01), history of arrhythmia with pacemaker placement (OR = 1.75; p = 0.02), and presence of a pre-op arrhythmia (OR = 1.62; p = 0.02).

Conclusion: Readmission after hip fracture is harmful and undesirable—18.6 % of readmitted patients died during their readmission and the average length of stay was 8.7 days. Approximately one of every six readmissions was identified as potentially preventable with interventions.

Original languageEnglish (US)
Pages (from-to)329-337
Number of pages9
JournalArchives of Orthopaedic and Trauma Surgery
Volume135
Issue number3
DOIs
StatePublished - Mar 2015
Externally publishedYes

Keywords

  • Complication
  • Geriatric fracture
  • Hip fracture
  • Mortality
  • Readmission

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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