Risk factors for early readmission due to surgical complications after treatment of proximal femoral fractures – A Finnish National Database study of 68,800 patients

Abstract

Introduction: Hip fracture surgery is associated with a considerable amount medical and surgical complications, which adversely impacts the patient's outcome and/or increases costs. We evaluated what risk factors were associated with the occurrence of early readmission due to surgical complications after hip fracture surgery. Material and methods: A nationwide database with 68,800 hip fracture patients treated between 1999 and 2011 was studied to uncover the association of readmissions with co-morbidities, fracture types, different hospital types and treatment methods using the Cox proportional hazards model. Results: Early readmission within three months due to hip fracture surgery complications occurred at a rate of 4.6%. Increased occurrence of readmission was found among patients with: heavy alcoholism (HR 1.38; 95% CI: 1.23-1.53); Parkinson's disease (PD; HR 1.22; 95% CI: 1.05-1.42); pre-existing osteoarthritis (HR 2.02; 95% CI: 1.83-2.23); rheumatic disease (HR 1.44; 95% CI: 1.27-1.65); as well as those with a fracture of the femur neck, depression, presence of a psychotic disorder, an operative delay of at least three days, or previous treatment with total hip arthroplasty. Conclusion: Our results indicate that there are several factors associated with an increased risk of early readmission. We suggest that in the presence of these factors, the surgical treatment method and postoperative protocol should be carefully planned and performed.

Sliding hip screw vs intramedullary nail for AO/OTA31A1-A3: a systematic review and meta-analysis

“…When using ROBINS-I, a fundamental part of the risk-of-bias assessment involves identifying and adjusting for possible confounders. Age, comorbidities and functional status were chosen to be the relevant confounding factors since they have all been found to be individual risk factors for major complications [60][61][62][63][64] . Both the ROB2 and ROBINS-I assessments were performed at the study level by two independent researchers (JOW and MPB) and later checked for any discrepancies in the results.…”

Impact of Parkinson's Disease on Complications, Readmission Rates, and Costs of Care following Primary Total Knee Arthroplasty

“…25 Of note, the authors also saw improvements in Knee Society pain scores from a mean of 34 points (0-50) preoperatively to 89 points (67-100) at 1 year postoperatively. 25 While the relationship between patients who had PD undergoing TKA and readmission rates has not been previously established, Yli-Kyyny et al 26 conducted a database study of 68,800 patients to investigate the most common risk factors for readmissions after treatment of proximal femoral fractures. Within this group, 3,384 patients were identified as having PD and an associated increased risk of early readmission rate was found.…”

“…Within this group, 3,384 patients were identified as having PD and an associated increased risk of early readmission rate was found. 26 In addition, Sofu et al 27 retrospectively investigated readmission rates after surgical treatment of hip fractures in 517 patients. A total of 63 patients were readmitted within 30 days and of these, 12 patients (19%) were identified as having PD or dementia ( p = 0.001).…”

The “Top 10” Psychosocial Factors Affecting Orthopaedic Outcomes

“…Tobacco and alcohol are also extremely prevalent in the orthopaedic patient population and known to be detrimental to surgical outcomes 56-62 . Although tobacco use seems to affect postoperative outcome in a dose-dependent manner, primarily because of its negative effect on tissue oxygenation and healing, alcohol seems to affect outcomes only in “heavy” drinkers, largely because of withdrawal symptoms and decreased rates of compliance 60,62 . However, this definition of “heavy” drinking is unclear.…”