title: Impact of comorbidity on 6-month hospital readmission and mortality after hip fracture surgery.
abstract: OBJECTIVE
  Impact of comorbidity on risk of readmission and death after hip fracture surgery has not been sufficiently explored. We planned to investigate the role of common diseases in predicting adverse events during recovery after hip surgery.
  
  
  METHODS
  We prospectively evaluated 272 consecutive patients (age, 82.6±8.9 years; 196 females, 72.1%) who underwent acute surgery for hip fracture at a regional university hospital. Baseline comorbidity and hospital stay were analysed. Number, timing and reasons for readmissions as well as mortality within 6 months after hospital discharge were recorded. An age- and sex-adjusted logistic regression model was applied to assess relations between comorbidity and relative risk of rehospitalisation or death.
  
  
  RESULTS
  Hypertension (44%), cognitive disorders (26%), and ischaemic heart disease (19%) were the most common comorbidities. The mean length-of-postoperative-stay was 12.7±7.9 days. Eighty-six patients (32%) were readmitted to hospital within 6 months from initial discharge and 36 patients (13%) died during that period. Increased risk of readmission was associated with hypertension (odds ratio (OR): 2.0, 95%CI, 1.2-1.9, p=0.009), and pacemaker treatment (OR: 6.6, 95%CI, 1.7-26.3, p=0.007), while there was a tendency towards readmission among men with prostate disease (OR: 5.0, 95%CI, 0.9-27.2, p=0.06). In contrast, mortality was predicted by ischaemic heart disease (OR: 2.2, 95%CI, 1.0-4.9, p=0.05), and malignancy (OR: 2.5, 95%CI, 1.1-5.7, p=0.04).
  
  
  CONCLUSIONS
  Common comorbidities are associated with higher risk of rehospitalisation and mortality following hip fracture surgery in the elderly. This information may be useful in postoperative risk assessment and prevention of negative outcomes.
authors: Department of Internal Medicine, Skåne University Hospital, SE 205-02 Malmö, Sweden; Department of Clinical Sciences, Lund University, Clinical Research Centre, Skåne University Hospital, SE 205-02 Malmö, Sweden.
authors: Maria
authors: M
authors: Härstedt
authors: Department of Orthopaedics, Skåne University Hospital, SE 205-02 Malmö, Sweden.
authors: Cecilia
authors: C
authors: Rogmark
authors: National Heart and Lung Institute, Imperial College, St Mary's Hospital Campus, 59-61 North Wharf Road, London W2 1LA, UK.
authors: Richard
authors: R
authors: Sutton
authors: Department of Internal Medicine, Skåne University Hospital, SE 205-02 Malmö, Sweden; Department of Clinical Sciences, Lund University, Clinical Research Centre, Skåne University Hospital, SE 205-02 Malmö, Sweden.
authors: Olle
authors: O
authors: Melander
authors: Department of Clinical Sciences, Lund University, Clinical Research Centre, Skåne University Hospital, SE 205-02 Malmö, Sweden; Department of Cardiology, Skåne University Hospital, SE 205-02 Malmö, Sweden. Electronic address: artur.fedorowski@med.lu.se.
authors: Artur
authors: A
authors: Fedorowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000401:mortality* / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D009369:Neoplasms / Q000401:mortality*; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality* / Q000601:surgery; D012307:Risk Factors; D013997:Time Factors
keywords: Comorbidity; Hip fracture; Mortality; Patient readmission; Risk factor