Impact of surgical complications on length of stay after hip fracture surgery.
BACKGROUND
Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact of surgical complications has not been examined in detail.


METHODS
All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall, infection or suboptimal surgery, stratified into either requiring reoperation or not allowing mobilisation because of instability.


RESULTS
Of the 600, 116 (19.3, 95% CI 16-22%) patients underwent reoperation or immobilisation; 27.1% of bed-day consumption resulted from surgical complications. The audit showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause.


CONCLUSIONS
Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50% of these hospital days might be spared by optimal surgery.
Foss
Nicolai B
NB
Department of Orthopaedic Surgery, Hvidovre University Hospital, Denmark. nbf@comxnet.dk
Palm
Henrik
H
Krasheninnikoff
Michael
M
Kehlet
Henrik
H
Gebuhr
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000534:rehabilitation*; D012189:Retrospective Studies