J Clin Outcomes Manage
Clinical predictors of prolonged hospitalization in patients with hip fracture
Marinella MA, Markert RJ
Abstract Objective: To determine if common clinical variables can predict increased length of stay (LOS) in patients over 50 years of age with fall-related hip fracture. Methods: We retrospectively analyzed the records of 183 consecutive patients 50 years or older admitted with hip fracture to a 750-bed teaching hospital. Data collected included demographic information, type of fracture, major comorbidities, type of surgical procedure, various admission laboratory values, postoperative complications, and LOS. Results: The patients’ mean age ± SD was 80.2 ± 10.2 years, 79% were female, and 85% were community dwellers. 90% of fractures involved the trochanteric region, and 92% underwent open reduction internal fixation. One patient died while 87% were discharged to an extended care facility or rehabilitation unit. On multivariable linear regression analysis, there were 6 independent predictors of increased LOS: postoperative respiratory failure (P < 0.001), postoperative infection (P < 0.001), postoperative cardiac complication (P = 0.001), postoperative delirium (P = 0.03), type of surgical procedure (P = 0.001), and admission platelet count (P = 0.004). Conclusion: Elderly patients with fall-related hip fractures with a low admission platelet count, who undergo total hip arthroplasty, or who develop postoperative respiratory failure, infection, cardiac dysfunction, or delirium have a longer hospital LOS. However, hospital morbidity is very low in this population, reinforcing the safety of surgical intervention in elderly patients with hip fracture.
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