title: [Length of hospital stay for patients with proximal femoral fractures : Influencing factors].
abstract: BACKGROUND
  In departments of orthopedic and trauma surgery patients with proximal femoral fractures constitute the largest proportion of trauma patients. The length of stay (LOS) has economic consequences and prolonged LOS leads to a shortage in bed capacity.
  
  
  OBJECTIVE
  In this study treatment and patient-related factors that influence the LOS of patients with proximal femoral fractures were investigated.
  
  
  METHODS
  Treatment and patient-related data of 242 patients (age >64 years) were recorded retrospectively and included residential aspects, legal guardianship, time of admission and surgery, hospital mortality, LOS, diagnosis, comorbidities, medication, surgical treatment, general and surgical complications, intensive care therapy and American Society of Anesthesiologists (ASA) classification.
  
  
  RESULTS
  Of the patients, one fifth came from a nursing home and were under supervised care or a healthcare proxy at the time of admission. Two thirds were admitted to hospital and operated on during on-call service periods. One half of the patients did not return to their previous domestic environment and were usually admitted to a nursing home. Patients who came from or were admitted to nursing homes, who were under healthcare supervision as well as patients who rapidly underwent surgery had a shorter LOS. Hospitalization and surgery during on-call service periods did not extend the LOS and showed a tendency towards reduction. Older age correlated with a longer LOS and surgical complications doubled the LOS.
  
  
  CONCLUSIONS
  Surgical treatment during on-call service periods, short preoperative waiting times and avoidance of surgical complications shortened LOS and thus had an impact on costs and bed capacity.
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie I, Westpfalz-Klinikum Kaiserslautern, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland. mmuhm@westpfalz-klinikum.de.
authors.forename: M
authors.initials: M
authors.lastname: Muhm
authors.affiliation: Evangelisches Krankenhaus Zweibrücken, Zweibrücken, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Walendowski
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie I, Westpfalz-Klinikum Kaiserslautern, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Danko
authors.affiliation: Abteilung für Medizinische Statistik, Biomathematik und Informationsverarbeitung, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Weiss
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie I, Westpfalz-Klinikum Kaiserslautern, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Ruffing
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie I, Westpfalz-Klinikum Kaiserslautern, Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Winkler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000401:mortality; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics* / Q000401:mortality / Q000601:surgery*; D006742:Hospital Bed Capacity / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000191:economics* / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate
keywords: Complications; Economic effects; Hospital bed capacity; Length of stay; Resources