Active clinical issues at discharge predict readmission within 30 days and one year following hip fracture surgery.

Key summary points: Aim: To investigate the impact of delay in surgery for medical causes and active clinical issues (ACIs) on 30-day readmission for medical causes after hip fracture surgery. Findings: ACIs were associated with readmissions following hip fracture surgery; however, no association between readmissions and reasons for delaying surgery was found. Message: Further studies into ACIs and reasons for delaying surgery are warranted to make more tailor-made treatment plans for patients with hip fracture. Purpose: To explore any association between 30-day readmission for medical causes and active clinical issues (ACIs), and to investigate the association between readmission and reasons for delaying surgery. Methods: We studied a consecutive cohort of hip fracture patients surgically treated from 2011 to 2017. Data were collected prospectively. ACIs were defined as unstable vital signs or antibiotic treatment at discharge. Reasons for delaying surgery beyond 24 and 36 h were divided into medical, organizational, or anticoagulation therapy. Results: A total of 2510 patients were included with a median age of 81 years and 67% were female. A total of 14% were readmitted within 30 days after hip fracture surgery. The most frequent causes of readmission were medical causes unrelated to the hip fracture (62%) and new trauma (13%). ACIs were associated with an increased risk of readmission and attributed to 46% of readmissions for medical causes. However, medical issues resulting in surgery delays exceeding > 24 h did not increase the risk of readmission for medical causes within 30 days. Conclusion: Readmission following hip fracture surgery is high, but some readmissions may be prevented. Resolving ACIs before discharge using tailor-made discharge plans and focused follow-up may reduce readmissions following hip fracture surgery. However, more studies into both ACIs and reasons for delaying surgery are warranted. [ABSTRACT FROM AUTHOR]