Impact of comorbidity on 6-month hospital readmission and mortality after hip fracture surgery

Abstract

Objectives Impact of comorbidity on risk of readmission and death after hip fracture surgery has not been sufficiently explored. We planned to investigate the role of common diseases in predicting adverse events during recovery after hip surgery. Patients and methods We prospectively evaluated 272 consecutive patients (age, 82.6 ± 8.9 years; 196 females, 72.1%) who underwent acute surgery for hip fracture at a regional university hospital. Baseline comorbidity and hospital stay were analysed. Number, timing and reasons for readmissions as well as mortality within 6 months after hospital discharge were recorded. An age- and sex-adjusted logistic regression model was applied to assess relations between comorbidity and relative risk of rehospitalisation or death. Results Hypertension (44%), cognitive disorders (26%), and ischaemic heart disease (19%) were the most common comorbidities. The mean length-of-postoperative-stay was 12.7 ± 7.9 days. Eighty-six patients (32%) were readmitted to hospital within 6 months from initial discharge and 36 patients (13%) died during that period. Increased risk of readmission was associated with hypertension (odds ratio (OR): 2.0, 95%CI, 1.2-1.9, p = 0.009), and pacemaker treatment (OR: 6.6, 95%CI, 1.7-26.3, p = 0.007), while there was a tendency towards readmission among men with prostate disease (OR: 5.0, 95%CI, 0.9-27.2, p = 0.06). In contrast, mortality was predicted by ischaemic heart disease (OR: 2.2, 95%CI, 1.0-4.9, p = 0.05), and malignancy (OR: 2.5, 95%CI, 1.1-5.7, p = 0.04). Conclusions Common comorbidities are associated with higher risk of rehospitalisation and mortality following hip fracture surgery in the elderly. This information may be useful in postoperative risk assessment and prevention of negative outcomes.