When does hip fracture surgery delay affects the length of hospital stay?

Kristan, Anže; Omahen, S; Tosounidis, Theodoros H.; Cimerman, Matej

doi:10.1007/s00068-020-01565-0

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Second, high BMI can make the surgical approach more difficult ( 35 ) which could disturb soft tissue vascularity leading to increased time for postoperative wound care. There is evidence that patients with hip arthroplasty have 3.3 days longer hospitalization compared to patients with osteosynthesis ( 27 ) which supports our finding that performing arthroplasty increases the risk of prolonged LOS. As to the choice of implants in a femoral neck fracture, internal fixation is generally recommended in cases of non-displaced fracture as there is a lower chance of disrupting the femoral head blood supply.…”

Section: Discussionsupporting

confidence: 86%

Predictive model for prolonged length of hospital stay in patients with osteoporotic femoral neck fracture: A 5-year retrospective study

Manosroi

Koetsuk²,

Phinyo³

et al. 2023

Front. Med.

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Prolonged length of stay (LOS) in osteoporotic femoral neck fracture patients increased the hospital care cost and demonstrated in-hospital complications. This study aimed to develop an ease-of use predictive model of prolonged LOS in osteoporotic femoral neck fracture patients. In this 5-year retrospective study, the medical charts of 255 patients admitted to hospital with an osteoporotic femoral neck fracture resulting from a simple fall from January 2014 to December 2018 were reviewed. Multivariable fractional polynomials (MFP) algorithms was applied to develop the predictive model from candidate predictors of prolonged LOS. The discrimination performance of predictive model was evaluated using the receiver operating characteristic curve (ROC). Internal validity was assessed using bootstrapping. From 289 patients who were hospitalized with an osteoporotic fracture of femoral neck throughout this study, 255 (88%) fulfilled the inclusion criteria. There was 54.90% (140 of 255 patients) of patients who had prolonged LOS. The predictors of the predictive model were age, BMI, ASA score class 3 or 4, arthroplasty and time from injury to surgery. The area under ROC curve of the model was 0.83 (95% confidence interval 0.77–0.88). Internal validation with bootstrap re-sampling revealed an optimism of −0.002 (range −0.300–0.296) with an estimated shrinkage factor of 0.907 for the predictive model. The current predictive model developed from preoperative predictors which had a good discriminative ability to differentiate between length of hospitalization less than 14 days and prolonged LOS in osteoporotic femoral neck patients. This model can be applied as ease-of use calculator application to help patients, their families and clinicians make appropriate decisions in terms of treatment planning, postoperative care program, and cost-effectiveness before patients receiving the definitive treatments.

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Section: Discussionsupporting

confidence: 86%

Predictive model for prolonged length of hospital stay in patients with osteoporotic femoral neck fracture: A 5-year retrospective study

Manosroi

Koetsuk²,

Phinyo³

et al. 2023

Front. Med.

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“…In addition, the authors suggested that ASA classification was a stronger predictor of LOS than the Charlson comorbidity index. Similar findings were shown by Kristan et al [ 24 ], who found that the eLOS was associated with delayed surgery, ASA classification, anticoagulant therapy and surgery type. Furthermore, a higher D-dimer level, as a possible predictor of DVT, suggested that patients were at higher risk of thrombosis, which was also the cause of eLOS[ 25 ].…”

Section: Discussionsupporting

confidence: 90%

“…In addition, patients with joint replacement surgery had higher functional requirements, which was why such patients took longer to stay and recover[ 29 , 30 ]. However, some studies mentioned the influence of age and comorbidities on the eLOS, but these factors were not identified by our model[ 24 , 27 , 30 ]. This might be due to changes in the management of hip fracture patients and the popularity of ERAS, which have allowed an increasing number of older patients with comorbidities to receive timely surgical treatment and rehabilitation guidance.…”

Section: Discussionmentioning

confidence: 99%

Machine learning applications for the prediction of extended length of stay in geriatric hip fracture patients

Tian,

Chen,

Shi

et al. 2023

World J Orthop

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Triggering, locking, clicking, and crepitus of the fingers are common symptoms patients present with. Even though crepitus and triggering can occur as part of the same underlying diagnosis, it is important to differentiate between them, as they usually indicate different possible diagnoses. The differential diagnoses that should be considered include trigger finger, metacarpophalangeal joint (MCPJ) arthritis, fractures or dislocations, extensor digitorum communis subluxation or dislocation, locked MCPJ, avascular necrosis of the metacarpal head, and Dupuytren’s disease. A thorough clinical examination with appropriate special investigations can permit the clinician to make the correct diagnosis. Appropriate management of a confirmed diagnosis is successful in providing symptomatic improvement.

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“…It is widely known that early surgery should be performed in elderly patients with hip fractures[ 35 ]. If the condition does not allow surgery to be performed and the waiting time for surgery is prolonged, there are many complications associated with prolonged bed rest, such as respiratory failure, urinary and genital tract infection, stones, bedsores, body temperature disorders, deep vein thrombosis, which ultimately affect the recovery of physical functions[ 36 ].…”

Section: Management To Address the Issuementioning

confidence: 99%

Management of hip fracture in COVID-19 infected patients

Qin¹,

He²,

Luo³

et al. 2022

WJO

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Given that the global population of elderly individuals is expanding and the difficulty of recovery, hip fractures will be a huge challenge and a critical health issue for all of humanity. Although people have spent more time at home during the coronavirus disease 2019 (COVID-19) pandemic, hip fractures show no sign of abating. Extensive studies have shown that patients with hip fracture and COVID-19 have a multifold increase in mortality compared to those uninfected and a more complex clinical condition. At present, no detailed research has systematically analyzed the relationship between these two conditions and proposed a comprehensive solution. This article aims to systematically review the impact of COVID-19 on hip fracture and provide practical suggestions. We found that hip fracture patients with COVID-19 have higher mortality rates and more complicated clinical outcomes. Indirectly, COVID-19 prevents hip fracture patients from receiving regular medical treatment. With regard to the problems we encounter, we provide clinical recommendations based on existing research evidence and a clinical flowchart for the management of hip fracture patients who are COVID-19 positive. Our study will help clinicians adequately prepare in advance when dealing with such patients and optimize treatment decisions.

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When does hip fracture surgery delay affects the length of hospital stay?

Cited by 6 publications

References 22 publications

Predictive model for prolonged length of hospital stay in patients with osteoporotic femoral neck fracture: A 5-year retrospective study

Predictive model for prolonged length of hospital stay in patients with osteoporotic femoral neck fracture: A 5-year retrospective study

Machine learning applications for the prediction of extended length of stay in geriatric hip fracture patients

Management of hip fracture in COVID-19 infected patients

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