Determinants Associated with Prolonged Hospital Stays for Patients Aged 65 Years or Older with a Vertebral Compression Fracture in a Rural Hospital in Japan

Abstract

Japan is an aging society, and the incidence of diseases related to aging, such as pneumonia, heart failure, vertebral compression fracture (VCF), is increasing. Prolonged hospital stays are becoming a serious social problem, leading to elevated medical expenses. Thus, shortening the period of hospitalization is important. This study aimed to reveal determinants associated with prolonged hospital stays for patients with VCF. Our institution is the primary hospital in a rural area in the Kanto region of Japan. Altogether, 110 patients with a VCF, aged 65 years or older, including 79 women, were divided into two groups according to the average hospital stay period of 28 days: the long-stay group (mean stay 40.0 ± 11.6 days, n = 39) and the short-stay group (mean stay 20.6 ± 4.4 days, n = 71). Notably, the short-stay group included 55 women. Multivariate logistic regression analyses in male showed no variates significantly associated with prolonged hospitalization. By contrast, multivariate logistic regression analyses in female showed requiring emergency transportation to hospital was significantly associated with prolonged hospitalization [odds ratio 7.69, 95% confidence interval 1.13-52.29, P = 0.04]. In conclusion, this study implies that patients with better levels of activities of daily living are able to walk alone sooner and are easily discharged. Furthermore, the patient requiring emergency transportation might be in a poor social living environment, such as living alone. These results may give us a good opportunity to reconsider fundamental problems surrounding the elderly.

Dependent person in self‐care: analysis of care needs

“…It should not be ignored that prolonged stay in acute hospitals increases the risk of cognitive impairment and functional dependency (18,19,26), in spite of nursing work in self-care training during the hospital stay and the planning of discharge which occurs with the involvement of the healthcare team. On the one hand, other studies have also demonstrated that prolonged hospital stays are associated with poorer functional status and mobility which in turn will affect the degree of dependency postdischarge (18,19,23,(26)(27)(28). On the other hand, the increase in dependency time seems to be followed by gains in autonomy, even though the correlations were not significant.…”

Biportal endoscopic posterior lumbar decompression and vertebroplasty for extremely elderly patients affected by lower lumbar delayed vertebral collapse with lumbosacral radiculopathy

“…We compared the length of stay in this study with the existing literature on lumbar laminectomy and conservative treatment for vertebral compression fracture. According to a study by Yusuke Watanabe et al, conservative treatment for vertebral compression fractures over 65 years of age results in a longer hospital stay and an average hospital stay of 20.6 ± 4.4 ~ 40.0 ± 11.6 days [ 18 ]. In addition, according to a study by Takeshi Oichi et al, in a study comparing microendoscopic laminectomy and open laminectomy, the average length of hospital stay was 12 and 16 days, respectively.…”