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[What risk factors are associated with mortality and readmissions in osteoporotic hip fracture?]

Authors :
Ruiz-Romero MV
Calero-Bernal ML
Carranza-Galván AB
Fernández-Moyano A
Blanco-Taboada AL
Fernández-Ojeda MR
Source :
Journal of healthcare quality research [J Healthc Qual Res] 2022 Sep-Oct; Vol. 37 (5), pp. 303-312. Date of Electronic Publication: 2022 Feb 11.
Publication Year :
2022

Abstract

Introduction and Objective: Hip fracture in the elderly leads to long hospital stays, readmissions and mortality.<br />Objective: To identify risk factors associated with mortality and readmissions in elderly with hip fracture.<br />Patients and Methods: Prospective observational study in people over 65years with hip fracture between October-2017 and November-2018, followed for 12months (128 patients).<br />Statistical Analysis: SPSS vs27.0.<br />Results: 6 (4.7%) patients were readmitted at 1 month; at year 24 (19.4%); 55 (44.4%) consulted for emergencies; 4 (3.1%) died during admission, and 26 (20.3%) in 12months; hospital stay 6.5 (SD: 4.80) days. Those with a previous Barthel less than 85 (6 [8.5%] vs 0 [0%]; P=.037) and less EuroQol5D (6 [10.0] vs 0 [0%]; P=.011) were readmitted more at one month. Those taking anticoagulants (OR: 3.33 (1.13-9.81); P=.003) and those with high surgical risk (18 [23.4%] vs 1 [5.6%]) were readmitted more after one year; P=.038). There was higher intra-episode mortality with renal failure (OR: 34.2 [3.25-359.93]; P=.003) and decompensated heart failure (OR: 23.8 [2.76-205.25]; P=.015). Higher mortality at one year in those older than 85years (OR: 4.3 [1.48-12.49]; P=.007); in those taking benzodiazepines (OR: 2.86 [1.06-7.73]; P=.038); if Barthel was less than 85 (OR: 2.96 [1.1-7.99]; P=.027) and if EuroQol5D was low (0.249 vs 0.547; P=.025). Those operated after 72h (24 [57.1%] vs. 29 [38.2%]; P=.047) consulted more for the emergency department.<br />Conclusions: Renal failure and cardiac decompensation increased intra-episode mortality. Older age, benzodiazepines, and previous low functionality and low EuroQol5D increased mortality at one year. They were readmitted more if higher surgical risk, previously anticoagulated and worse quality of life and functionality.<br /> (Copyright © 2022 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Details

Language :
Spanish; Castilian
ISSN :
2603-6479
Volume :
37
Issue :
5
Database :
MEDLINE
Journal :
Journal of healthcare quality research
Publication Type :
Academic Journal
Accession number :
35165076
Full Text :
https://doi.org/10.1016/j.jhqr.2021.11.004