Outcomes in older patients after surgical treatment for hip fracture: A new approach to characterise the link between readmissions and the surgical stay. Teixeira, A., Trinquart, L., Raphael, M., Bastianic, T., Chatellier, G., & Holstein, J. Age and Ageing, 38(5):584-589, 2009.
Outcomes in older patients after surgical treatment for hip fracture: A new approach to characterise the link between readmissions and the surgical stay [pdf]Paper  abstract   bibtex   
BACKGROUND: in older patients, there is a high risk of hospital readmission within the first year after surgery for hip fracture, due to complications following treatment or to the evolution of prior comorbid conditions. OBJECTIVES: to identify factors associated with readmissions related to the index surgical stay. DESIGN: retrospective cohort study. SETTING: administrative claims databases. SUBJECTS: patients over 75 surgically treated for hip fracture in Paris area. METHODS: we analysed all admissions in 2005, and tracked for 1-year readmissions. First readmissions (FRs) were classified as related or unrelated to the index stay, according to rules defined a priori. We analysed the association between patient characteristics and the FR. RESULTS: among 5,709 patients, 32% had at least one readmission, 53% were FR related. Near 80% of related readmissions occurred within 3 months from discharge. Surgical conditions caused 47% of all related readmissions, and male gender, dementia, cancer or kidney diseases were independent risks factors. CONCLUSIONS: half of readmissions could be classified as related to the index stay and a great majority of these occurred early post discharge. Surgical conditions caused 47% of all related readmissions. Improvement in orthopedic-geriatric co-care is suitable to expect an impact on outcomes after surgery.

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