Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Department of Joint Surgery, Huai 'an Hospital of Huai'an City, Huai'an, People's Republic of China.
Clin Interv Aging. 2023 Mar 1;18:317-326. doi: 10.2147/CIA.S395012. eCollection 2023.
The purpose of this study was to examine the incidence and cause of unplanned readmission after Surgically Treated Hip Fractures in Elderly Patients and identify the associated risk factors.
This study retrospectively collected the data on elderly patients who underwent hip fracture surgery at two institutions from January 2020 to December 2021, and identified those who were readmitted within 12 months postoperatively. Based on the presence or not of postoperative readmission, they were divided into readmission and non-readmission groups. Demographics, surgery-related variables, and laboratory parameters were compared between groups. The specific causes for documented readmission were collected and summarized. Multivariate logistic regression analysis was performed to identify the associated risk factors.
There were 930 patients including 76 (8.2%) patients who were readmitted within 12 months postoperatively. Overall, cardiac and respiratory complications and new-onset fractures were the first three common causes of readmission, taking an overwhelming proportion of 53.9% (41/76). Over 60% (61.8%, 47/76) of readmissions occurred within 30 days after surgery, with medical complications taking a predominance (89.4%, 42/47). New-onset fractures accounted for a proportion of 18.4% (14/76), occurring at different time points; especially, at 90-365 days, it accounted for 44.4% (8/18). Multivariate analysis revealed that age ≥80 years (OR, 1.0, 95% CI, 1.0 to 1.1; P=0.032), preoperative albumin level ≤21.5 g/L (OR, 1.1, 95% CI, 1.0 to 1.2; P=0.009), the postoperative occurrence of DVT (OR, 4.2, 95% CI, 2.5 to 7.2; P=0.001), and local anesthesia (OR, 2.1, 95% CI, 1.1 to 4.0; P=0.029) were independent risk factors for unplanned readmissions.
This study identified several risk factors for unplanned readmissions after elderly hip fractures, and provided detailed information about unplanned readmissions.
本研究旨在探讨老年患者手术后髋部骨折的非计划性再入院发生率和原因，并确定相关的危险因素。
本研究回顾性收集了 2020 年 1 月至 2021 年 12 月在两家机构接受髋关节骨折手术的老年患者的数据，并确定了术后 12 个月内再入院的患者。根据术后是否再入院，将其分为再入院组和非再入院组。比较两组患者的人口统计学、手术相关变量和实验室参数。收集并总结了有记录的再入院的具体原因。采用多变量逻辑回归分析确定相关的危险因素。
共纳入 930 例患者，其中 76 例（8.2%）患者在术后 12 个月内再入院。总体而言，心脏和呼吸系统并发症以及新发骨折是再入院的前三个常见原因，占比高达 53.9%（41/76）。超过 60%（61.8%，47/76）的再入院发生在术后 30 天内，其中医疗并发症占主导地位（89.4%，42/47）。新发骨折占 18.4%（14/76），发生在不同的时间点；特别是在 90-365 天，占 44.4%（8/18）。多变量分析显示，年龄≥80 岁（OR，1.0，95%CI，1.0 至 1.1；P=0.032）、术前白蛋白水平≤21.5 g/L（OR，1.1，95%CI，1.0 至 1.2；P=0.009）、术后发生 DVT（OR，4.2，95%CI，2.5 至 7.2；P=0.001）和局部麻醉（OR，2.1，95%CI，1.1 至 4.0；P=0.029）是老年髋部骨折非计划性再入院的独立危险因素。
本研究确定了老年髋部骨折后非计划性再入院的几个危险因素，并提供了非计划性再入院的详细信息。
