Readmission Rates After Hip Fracture: Are There Prefracture Warning Signs for Patients Most at Risk of Readmission?

Abstract

Background: The purpose of this study was to evaluate known and yet unknown risk factors associated with readmission to the hospital within 30 days after hip fracture. Methods: In this study, we used the Cerner Health Facts Electronic Health Record database data from January to August 2015. The univariate association of each variable (discharge location, demographic details, and comorbidities) against the 30-day readmission status was evaluated using the Chi-square test or the Fisher exact test. The significant variables (P < 0.05) obtained by the univariate analysis were used to build the multivariate logistic regression model to evaluate the multivariate associations of the variables. Results: Thirty-four thousand seven hundred ninety index admissions of 33,740 unique patients were included in the study cohort. The overall 30-day readmission rate for patients with hip fractures was 10.7%. We demonstrated a new variable not discussed in previous articles on this topic: patients with previous inpatient/emergency visits within the past year were more likely to be readmitted within 30 days after the hip fracture surgery (P < 0.001). Conclusion: For patients with hip fractures, particular efforts should be taken to optimize outcomes in those with recent hospitalizations and/or discharge to a location other than home.

Outcomes of hip fracture surgery during the COVID-19 pandemic

“…In their multicenter database study, Checketts et al reported that male patients were more likely to be readmitted than female patients after HFx [ 20 ]. The same study by Checketts et al reported a possible ceiling effect of age on readmission rates, with older patients having a higher risk prior to 75 years, whereas after 75 years the association became stable [ 20 ]. While our data was significant for association between age and mortality, it is possible that a similar principle could be applied.…”

“…Previous studies have reported 30-day readmission rates for HFx between 10.7% to 11.9% and 90-day readmission rates around 19.7% [ 20 – 22 ]. Our secondary outcome results are in line with previous literature as 30- and 90-day readmission rates prior to the pandemic were 13.7% and 13.3%, respectively [ 20 – 22 ]. During the pandemic, our 30- and 90-day readmission rates were 12.4% and 7.8%, respectively.…”

“…Upon more in depth investigation into how intragroup demographic variability affected post-surgical outcomes, it was shown that patients who were below the age of 75 had a 4.65 increased odds for overall mortality and patients who were male had a 2.10 increased odds for overall readmissions. In their multicenter database study, Checketts et al reported that male patients were more likely to be readmitted than female patients after HFx [ 20 ]. The same study by Checketts et al reported a possible ceiling effect of age on readmission rates, with older patients having a higher risk prior to 75 years, whereas after 75 years the association became stable [ 20 ].…”

“…While our data was significant for association between age and mortality, it is possible that a similar principle could be applied. Age is generally associated with higher risk of complications, so the specific reason why patients under the age of 75 had increased odds for overall mortality in our cohort is unclear [ 20 ]. This could indicate potential factors that could be affecting post-surgical outcome measures that are beyond the scope of this particular study, but may warrant further investigation in future.…”

Previous Emergency Department Admission Is Associated With Increased 90-Day Readmission Following Cervical Spine Surgery

“…15 By gaining a better understanding of the risk factors of patients who experience readmission, it is possible to focus on improving the quality of care and reducing the cost of care for these at-risk populations. 7,11 Our study evaluates the Nationwide Readmissions Database to examine readmission rates after cervical spinal fusion. Using this database, we evaluate both known and currently unknown risk factors associated with readmission to the hospital within 90 days following initial discharge.…”