Chen X, Liao Z, Shen Y, Dong B, Hou L, Hao Q
Qiukui Hao, MD, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Email:
J Nutr Health Aging. 2021;25(8):951-955. doi: 10.1007/s12603-021-1656-9.
To investigate the association between pre-admission waiting time and postoperative complications, length of stay (LOS), and costs during hospitalization.
This was a single-center, observational study. The subjects of this study were elderly hip fracture patients who were admitted to the Department of Orthopedics, West China Hospital, Sichuan University, from December 2010 to June 14, 2017, and that underwent internal fixation or joint replacement surgery. The pre-admission waiting time was treated as a categorical variable according to median and first quartile values. Outcomes included postoperative complications (pneumonia and other complications [urinary tract infection, heart failure, non-A-grade healing]), LOS, and costs during hospitalization. LOS and costs during hospitalization were converted into binary outcomes based upon median values. Binary logistic regression analyses were used to analyze correlations between pre-admission waiting time and patient outcomes.
A total of 889 patients 60 years of age and older were enrolled in this study, of whom 65.47% were females and 34.53% were males. The proportion of patients with pre-admission waiting times less than 8 h, 8 - 24 h, and ≥ 24 h were 24.3%, 17.32%, and 58.38%, respectively. Postoperative pneumonia and other complications affected 12.04% and 6.30% of patients, respectively. Relative to patients with the pre-admission waiting times of less than 8 h, those with longer pre-admission waiting times exhibited a higher risk of postoperative pneumonia (8 - 24 h: OR = 2.72,95% CI: 1.29-5.74, p = 0.009; ≥ 24 h: OR = 2.76,95% CI: 1.48-5.14, p = 0.001). Patients with the pre-admission waiting time ≥ 24 h also exhibited a higher risk of the other complications (OR = 2.55, 95% CI: 1.53-4.26, p <0.001), a longer LOS (OR = 1.43, 95% CI:1.02-2.01, p = 0.036), and higher costs during hospitalization (OR = 1.51, 95% CI:1.05 - 2.17, p = 0.026) relative to patients with a waiting time less than 8 hours.
Pre-admission waiting time was associated with postoperative complications, LOS, and hospitalization costs among older Chinese patients undergoing surgery to treat hip fractures.
研究入院前等待时间与术后并发症、住院时间（LOS）及住院费用之间的关联。
这是一项单中心观察性研究。本研究的对象为2010年12月至2017年6月14日期间入住四川大学华西医院骨科并接受内固定或关节置换手术的老年髋部骨折患者。入院前等待时间根据中位数和第一四分位数作为分类变量处理。结局指标包括术后并发症（肺炎及其他并发症[尿路感染、心力衰竭、非甲级愈合]）、住院时间及住院费用。住院时间和住院费用根据中位数转化为二分类结局。采用二分类逻辑回归分析来分析入院前等待时间与患者结局之间的相关性。
本研究共纳入889例60岁及以上患者，其中女性占65.47%，男性占34.53%。入院前等待时间小于8小时、8 - 24小时及≥24小时的患者比例分别为24.3%、17.32%和58.38%。术后肺炎和其他并发症分别影响12.04%和6.30%的患者。与入院前等待时间小于8小时的患者相比，入院前等待时间较长的患者术后肺炎风险更高（8 - 24小时：OR = 2.72，95%CI：1.29 - 5.74，p = 0.009；≥24小时：OR = 2.76，95%CI：1.48 - 5.14，p = 0.001）。入院前等待时间≥24小时的患者其他并发症风险也更高（OR = 2.55，95%CI：1.53 - 4.26，p <0.001），住院时间更长（OR = 1.43，95%CI：1.02 - 2.01，p = 0.036），且住院费用更高（OR = 1.51，95%CI：1.05 - 2.17，p = 0.026），相对于等待时间小于8小时的患者。
对于接受髋部骨折手术治疗的中国老年患者，入院前等待时间与术后并发症、住院时间及住院费用相关。
