Outcomes in older patients after surgical treatment for hip fracture: a new approach to characterise the link between readmissions and the surgical stay.
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.


OBJECTIVE
to identify factors associated with readmissions related to the index surgical stay.


METHODS
retrospective cohort study.


METHODS
administrative claims databases.


METHODS
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.
Teixeira
Antonio
A
Service de Médecine Gériatrique, HGMS de Plaisir Grignon, 78375 Plaisir, France.
Trinquart
Ludovic
L
Raphael
Mathilde
M
Bastianic
Tanja
T
Chatellier
Gilles
G
Holstein
Josiane
J
D000208:Acute Disease; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003704:Dementia / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery*; D006751:Hospital Information Systems; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution