Pettit Christopher J, Herbosa Carolyn F, Ganta Abhishek, Rivero Steven, Tejwani Nirmal, Leucht Philipp, Konda Sanjit R, Egol Kenneth A
Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and.
Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY.
J Orthop Trauma. 2025 Apr 1;39(4):200-206. doi: 10.1097/BOT.0000000000002946.
To determine the most common reason for 30-day readmission after hospitalization for hip fractures.
A retrospective review.
Single academic medical center that includes a Level 1 trauma center.
Included were all patients operatively treated for hip fractures (OTA 31) between October 2014 and November 2023. Patients who died during their initial admission were excluded.
Patient demographics, hospital quality measures, outcomes, and readmission within 30 days after discharge for each patient were reviewed. Thirty-day readmission reason was recorded and correlation analysis was performed.
A total of 3032 patients were identified with a mean age of 82.1 years and 70.5% of patients being women. The 30-day readmission cohort was 2.6 years older ( P < 0.001) and 8.8% more male patients ( P = 0.027), had 0.5 higher Charleston comorbidity index ( P < 0.001), 0.3 higher American Society of Anesthesiologists class ( P < 0.001), and were 9.2% less independent at the time of admission ( P = 0.003). Hemiarthroplasty procedure (32.7% vs. 24.1%) was associated with higher 30-day readmission compared with closed percutaneous screw fixation (4.5% vs. 8.8%) and cephalomedullary nail fixation (52.2% vs. 54.4%, P < 0.001). Those readmitted by 30 days developed more major (16.7% vs. 8.0%; P < 0.001) and minor (50.5% vs. 36.4%; P < 0.001) complications during their initial hospitalization and had a 1.5-day longer length of stay during their first admission ( P < 0.001). Those discharged home were less likely to be readmitted within 30 days (20.7% vs. 27.6%, P = 0.008). Multivariate regression revealed increasing American Society of Anesthesiologists class (odds ratio 1.47, P = 0.002) and preinjury ambulatory status (odds ratio 1.42, P = 0.007) was most associated with increased 30-day readmission. The most common reason for readmission was pulmonary complications (17.1% of complications) including acute respiratory failure, chronic obstructive pulmonary disease exacerbation, and pneumonia.
Thirty-day readmission after hip fracture was associated with older, sicker patients with decreased preinjury ambulation status. Hemiarthroplasty for femoral neck fracture was also associated with readmission. The most common reason for 30-day readmission after hip fracture was pulmonary complications.
Prognostic Level III. See instructions for authors for a complete description of levels of evidence.
确定髋部骨折住院后30天再入院的最常见原因。
回顾性研究。
一家设有一级创伤中心的单一学术医学中心。
纳入2014年10月至2023年11月期间接受手术治疗的所有髋部骨折患者（OTA 31）。排除初次住院期间死亡的患者。
回顾每位患者的人口统计学资料、医院质量指标、结局以及出院后30天内的再入院情况。记录30天再入院原因并进行相关性分析。
共纳入3032例患者，平均年龄82.1岁，70.5%为女性。30天再入院队列患者年龄大2.6岁（P<0.001），男性患者多8.8%（P=0.027），Charleston合并症指数高0.5（P<0.001），美国麻醉医师协会分级高0.3（P<0.001），入院时独立程度低9.2%（P=0.003）。与闭合经皮螺钉固定（4.5%对8.8%）和髓内钉固定（52.2%对54.4%，P<0.001）相比，半髋关节置换术（32.7%对24.1%）与30天再入院率较高相关。30天内再入院的患者在初次住院期间发生更多严重（16.7%对8.0%；P<0.001）和轻微（50.5%对36.4%；P<0.001）并发症，首次住院时间长1.5天（P<0.001）。出院回家的患者30天内再入院的可能性较小（20.7%对27.6%，P=0.008）。多因素回归显示，美国麻醉医师协会分级增加（比值比1.47，P=0.002）和伤前活动状态（比值比1.42，P=0.007）增加与30天再入院增加最相关。再入院最常见的原因是肺部并发症（占并发症的17.1%），包括急性呼吸衰竭、慢性阻塞性肺疾病加重和肺炎。
髋部骨折后30天再入院与年龄较大、病情较重且伤前活动状态下降的患者相关。股骨颈骨折的半髋关节置换术也与再入院相关。髋部骨折后30天再入院最常见的原因是肺部并发症。
预后III级。有关证据水平的完整描述，请参阅作者指南。
