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

Publication date: Available online 16 November 2018

Source: Injury

Author(s): Tero T. Yli-Kyyny, Reijo Sund, Mikko Heinänen, Antti Malmivaara, Heikki Kröger

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.

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