title: Hospital readmission after hip fracture.
abstract: BACKGROUND
  Readmission to the hospital following a hip fracture is common, often involves an adverse event, and strains an already overburdened health care system.
  
  
  OBJECTIVE
  To assess the rate of 30-day readmission to the hospital after discharge for care of hip fracture. A secondary objective was measurement of the 30-day mortality rate for those patients readmitted versus those patients not readmitted to the hospital after discharge.
  
  
  METHODS
  Study design was a retrospective review of registry data comparing readmitted patients to those not readmitted after hip fracture. Setting was a university affiliated level 3 trauma center.
  
  
  METHODS
  1,081 patients aged 65 and older.
  
  
  METHODS
  rate of readmission, rate of mortality, predictors of readmission.
  
  
  RESULTS
  129 patients (11.9 %) were readmitted to the hospital within 30 days of their initial discharge date. The primary causes of readmission were surgical in nature for 24/129 (18.6 %) patients and 105/129 (81.4 %) were readmitted for medical or other reasons. Twenty-four (18.6 %) patients who were readmitted died during readmission. The one-year mortality rate for patients readmitted within 30 days was 56.2 vs. a 21.8 % 1-year mortality rate for those patients not readmitted (p < 0.0001). Independent predictors of readmission were age >85 (OR = 1.52; p = 0.03), time to surgery >24 h (OR = 1.50; p = 0.05), Charlson score ≥4 (OR = 1.70; p = 0.04), delirium (OR = 1.65; p = 0.01), dementia (OR = 1.61; p = 0.01), history of arrhythmia with pacemaker placement (OR = 1.75; p = 0.02), and presence of a pre-op arrhythmia (OR = 1.62; p = 0.02).
  
  
  CONCLUSIONS
  Readmission after hip fracture is harmful and undesirable-18.6 % of readmitted patients died during their readmission and the average length of stay was 8.7 days. Approximately one of every six readmissions was identified as potentially preventable with interventions.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA, Stephen_kates@urmc.rochester.edu.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Kates
authors.forename: Caleb
authors.initials: C
authors.lastname: Behrend
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mendelson
authors.forename: Peter
authors.initials: P
authors.lastname: Cram
authors.forename: Susan M
authors.initials: SM
authors.lastname: Friedman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies