Hospital Readmission Rate and Risk Factors in Elderly Patients after a Hip Fracture

Abstract

INTRODUCTION: Elderly patients with hip fracture are at high risk for complications and in-hospital mortality. Short hospital stay and early discharge with still active clinical problems may lead to readmissions. OBJECTIVES: to know the rate of readmissions, the reasons and the predictive variables in patients who had hip fractures. METHODS: A retrospective cohort study was performed, with all patients included in the institutional registry of elderly patients with hip fracture between July 2014 and July 2017. Readmission rates and their CI95% were described. A proportional risk Cox model was used to describe risk factors and time-toreadmission. RESULTS: A total of 858 patients were included with a median hospital stay of 6 days (interquartile range [IQR] 5-9), 86% (737) of female patients and a median age of 86 years (IQR 81-89). Readmission rates were 10% (CI95%: 8.3-12.5) at 30 days and 39% (CI95%: 34.8-42.6) at 12 months. The main cause was infection (30%). Associated factors were: age (>85 years) HR 1.3 (CI95%: 1-1.7; p 0.03), female gender HR 0.5 (CI95%: 0.4-0.7; p<0.01), fragility HR 1.4 (CI95%: 1.1-1.8; p<0.01), Charlson score (≥2) HR 1.6 (CI95%: 1.3-2.1; p<0.01), hospital stay (>7 days) HR 1.4 (CI95%: 1.2- 1.9, p<0.01). CONCLUSIONS: Readmission after hip fracture has a high incidence. Perioperative care of patients with hip fracture is essential to reduce complications.