Re-admissions following hip fracture surgery

Abstract

INTRODUCTION: Hip fractures in the elderly are a growing problem with a predicted incidence of 117,000 cases per year by 2016. Re-admission following a healthcare episode is an important outcome measure, which reflects non-fatal adverse events and indicates the natural history of disease. The purpose of this observational, multicentre audit was to examine rates and reasons for re-admission following hip fracture, to identify areas in the index admission and rehabilitation care that could be improved to prevent re-admission. PATIENTS AND METHODS: A total of 535 patients (> 65 years old) in two district general hospitals in the UK who underwent hip fracture surgery were recruited into the study. RESULTS: Of the study cohort, 72 patients (13.5%) died during their index admission and 88 (19.0%) of 463 patients were re-admitted once within 3 months. Causes of re-admission were attributed to medical (54.8%), failure to rehabilitate (23.8%), orthopaedic (19.0%) and surgical (2.4%) reasons. Infection was the most common (31.0%) reason for re-admission and arguably the most treatable. During the 3-month postoperative period, the mortality rate was 21.3%, increasing in those readmitted to 35.1% representing the frailty of this group of patients. CONCLUSIONS:High rates of re-admission are seen following discharge in elderly patients with hip fractures. Re-admitted patients have high mortality rates. Understanding causes of re-admission may help to reduce this burden.