Re-admissions following hip fracture surgery.
BACKGROUND
Hip fractures in the elderly are a growing problem with a predicted incidence of 117,000 cases per year by 2016. Re-admission following a healthcare episode is an important outcome measure, which reflects non-fatal adverse events and indicates the natural history of disease. The purpose of this observational, multicentre audit was to examine rates and reasons for re-admission following hip fracture, to identify areas in the index admission and rehabilitation care that could be improved to prevent re-admission.


METHODS
A total of 535 patients (> 65 years old) in two district general hospitals in the UK who underwent hip fracture surgery were recruited into the study.


RESULTS
Of the study cohort, 72 patients (13.5%) died during their index admission and 88 (19.0%) of 463 patients were re-admitted once within 3 months. Causes of re-admission were attributed to medical (54.8%), failure to rehabilitate (23.8%), orthopaedic (19.0%) and surgical (2.4%) reasons. Infection was the most common (31.0%) reason for re-admission and arguably the most treatable. During the 3-month postoperative period, the mortality rate was 21.3%, increasing in those re-admitted to 35.1% representing the frailty of this group of patients.


CONCLUSIONS
High rates of re-admission are seen following discharge in elderly patients with hip fractures. Re-admitted patients have high mortality rates. Understanding causes of re-admission may help to reduce this burden.
Hahnel
James
J
Department of Orthopaedics and Trauma, Yorkshire Deanery, University of Leeds, Leeds, UK. jamesh@doctors.org.uk
Burdekin
Hannah
H
Anand
Sanjeev
S
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004739:England; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*