Hospital readmissions after hospital discharge for hip fracture: Surgical and nonsurgical causes and effect on outcomes

Kenneth S. Boockvar, Ethan A. Halm, Ann Litke, Stacey B. Silberzweig, MaryAnn McLaughlin, Joan D. Penrod, Jay Magaziner, Kenneth Koval, Elton Strauss, Albert L. Siu

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

OBJECTIVES: To examine the causes of hospital readmission after hip fracture and the relationships between hospital readmission and 6-month physical function and mortality. DESIGN: Prospective, multisite, observational cohort study. SETTING: Four hospitals in the New York City metropolitan area. PARTICIPANTS: Five hundred sixty-two patients hospitalized for hip fracture aged 50 and older and discharged alive in 1997-1998. MEASUREMENTS: Patient demographic characteristics, type of fracture and repair, comorbid conditions, postoperative complications, do not resuscitate status, and active clinical problems at the time of hospital discharge. Prefracture and 6-month mobility were measured using the Functional Independence Measure. Hospital readmissions and International Classification of Diseases, Ninth Revision principal diagnoses were ascertained from hospital admission/discharge databases, the New York Statewide Planning and Research Cooperative System, medical record review, and patient self-report. RESULTS: Eighty-two percent of participants were women, and 93% were white. Within 6 months after hospital discharge, 178 (32%) patients were readmitted to the hospital, with 45 (8%) readmitted more than once. Forty-seven of 233 readmissions (20%) occurred within the first 2 weeks after discharge, and 80 (34%) occurred within 4 weeks. Over 6 months, 89% of readmissions were for nonsurgical problems, of which infectious (21%) and cardiac (12%) diseases were the most common. In multivariate analyses, patients who were readmitted were more likely to require total assistance with ambulation at 6 months (odds ratio (OR) = 2.7, 95% confidence interval (CI) = 1.6-4.6) and to die (OR = 4.0, 95% CI = 2.2-7.3) than those not readmitted. CONCLUSION: Hospital readmissions after hip fracture are largely due to nonsurgical illness and are associated with increased morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)399-403
Number of pages5
JournalJournal of the American Geriatrics Society
Volume51
Issue number3
DOIs
StatePublished - Mar 1 2003

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Patient Readmission
Hip Fractures
Odds Ratio
Confidence Intervals
Mortality
International Classification of Diseases
Self Report
Walking
Medical Records
Observational Studies
Heart Diseases
Cohort Studies
Multivariate Analysis
Demography
Databases
Morbidity
Research

Keywords

  • Disability
  • Hip fractures
  • Mortality
  • Patient readmission

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Hospital readmissions after hospital discharge for hip fracture : Surgical and nonsurgical causes and effect on outcomes. / Boockvar, Kenneth S.; Halm, Ethan A.; Litke, Ann; Silberzweig, Stacey B.; McLaughlin, MaryAnn; Penrod, Joan D.; Magaziner, Jay; Koval, Kenneth; Strauss, Elton; Siu, Albert L.

In: Journal of the American Geriatrics Society, Vol. 51, No. 3, 01.03.2003, p. 399-403.

Research output: Contribution to journalArticle

Boockvar, KS, Halm, EA, Litke, A, Silberzweig, SB, McLaughlin, M, Penrod, JD, Magaziner, J, Koval, K, Strauss, E & Siu, AL 2003, 'Hospital readmissions after hospital discharge for hip fracture: Surgical and nonsurgical causes and effect on outcomes', Journal of the American Geriatrics Society, vol. 51, no. 3, pp. 399-403. https://doi.org/10.1046/j.1532-5415.2003.51115.x
Boockvar, Kenneth S. ; Halm, Ethan A. ; Litke, Ann ; Silberzweig, Stacey B. ; McLaughlin, MaryAnn ; Penrod, Joan D. ; Magaziner, Jay ; Koval, Kenneth ; Strauss, Elton ; Siu, Albert L. / Hospital readmissions after hospital discharge for hip fracture : Surgical and nonsurgical causes and effect on outcomes. In: Journal of the American Geriatrics Society. 2003 ; Vol. 51, No. 3. pp. 399-403.
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abstract = "OBJECTIVES: To examine the causes of hospital readmission after hip fracture and the relationships between hospital readmission and 6-month physical function and mortality. DESIGN: Prospective, multisite, observational cohort study. SETTING: Four hospitals in the New York City metropolitan area. PARTICIPANTS: Five hundred sixty-two patients hospitalized for hip fracture aged 50 and older and discharged alive in 1997-1998. MEASUREMENTS: Patient demographic characteristics, type of fracture and repair, comorbid conditions, postoperative complications, do not resuscitate status, and active clinical problems at the time of hospital discharge. Prefracture and 6-month mobility were measured using the Functional Independence Measure. Hospital readmissions and International Classification of Diseases, Ninth Revision principal diagnoses were ascertained from hospital admission/discharge databases, the New York Statewide Planning and Research Cooperative System, medical record review, and patient self-report. RESULTS: Eighty-two percent of participants were women, and 93{\%} were white. Within 6 months after hospital discharge, 178 (32{\%}) patients were readmitted to the hospital, with 45 (8{\%}) readmitted more than once. Forty-seven of 233 readmissions (20{\%}) occurred within the first 2 weeks after discharge, and 80 (34{\%}) occurred within 4 weeks. Over 6 months, 89{\%} of readmissions were for nonsurgical problems, of which infectious (21{\%}) and cardiac (12{\%}) diseases were the most common. In multivariate analyses, patients who were readmitted were more likely to require total assistance with ambulation at 6 months (odds ratio (OR) = 2.7, 95{\%} confidence interval (CI) = 1.6-4.6) and to die (OR = 4.0, 95{\%} CI = 2.2-7.3) than those not readmitted. CONCLUSION: Hospital readmissions after hip fracture are largely due to nonsurgical illness and are associated with increased morbidity and mortality.",
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T1 - Hospital readmissions after hospital discharge for hip fracture

T2 - Surgical and nonsurgical causes and effect on outcomes

AU - Boockvar, Kenneth S.

AU - Halm, Ethan A.

AU - Litke, Ann

AU - Silberzweig, Stacey B.

AU - McLaughlin, MaryAnn

AU - Penrod, Joan D.

AU - Magaziner, Jay

AU - Koval, Kenneth

AU - Strauss, Elton

AU - Siu, Albert L.

PY - 2003/3/1

Y1 - 2003/3/1

N2 - OBJECTIVES: To examine the causes of hospital readmission after hip fracture and the relationships between hospital readmission and 6-month physical function and mortality. DESIGN: Prospective, multisite, observational cohort study. SETTING: Four hospitals in the New York City metropolitan area. PARTICIPANTS: Five hundred sixty-two patients hospitalized for hip fracture aged 50 and older and discharged alive in 1997-1998. MEASUREMENTS: Patient demographic characteristics, type of fracture and repair, comorbid conditions, postoperative complications, do not resuscitate status, and active clinical problems at the time of hospital discharge. Prefracture and 6-month mobility were measured using the Functional Independence Measure. Hospital readmissions and International Classification of Diseases, Ninth Revision principal diagnoses were ascertained from hospital admission/discharge databases, the New York Statewide Planning and Research Cooperative System, medical record review, and patient self-report. RESULTS: Eighty-two percent of participants were women, and 93% were white. Within 6 months after hospital discharge, 178 (32%) patients were readmitted to the hospital, with 45 (8%) readmitted more than once. Forty-seven of 233 readmissions (20%) occurred within the first 2 weeks after discharge, and 80 (34%) occurred within 4 weeks. Over 6 months, 89% of readmissions were for nonsurgical problems, of which infectious (21%) and cardiac (12%) diseases were the most common. In multivariate analyses, patients who were readmitted were more likely to require total assistance with ambulation at 6 months (odds ratio (OR) = 2.7, 95% confidence interval (CI) = 1.6-4.6) and to die (OR = 4.0, 95% CI = 2.2-7.3) than those not readmitted. CONCLUSION: Hospital readmissions after hip fracture are largely due to nonsurgical illness and are associated with increased morbidity and mortality.

AB - OBJECTIVES: To examine the causes of hospital readmission after hip fracture and the relationships between hospital readmission and 6-month physical function and mortality. DESIGN: Prospective, multisite, observational cohort study. SETTING: Four hospitals in the New York City metropolitan area. PARTICIPANTS: Five hundred sixty-two patients hospitalized for hip fracture aged 50 and older and discharged alive in 1997-1998. MEASUREMENTS: Patient demographic characteristics, type of fracture and repair, comorbid conditions, postoperative complications, do not resuscitate status, and active clinical problems at the time of hospital discharge. Prefracture and 6-month mobility were measured using the Functional Independence Measure. Hospital readmissions and International Classification of Diseases, Ninth Revision principal diagnoses were ascertained from hospital admission/discharge databases, the New York Statewide Planning and Research Cooperative System, medical record review, and patient self-report. RESULTS: Eighty-two percent of participants were women, and 93% were white. Within 6 months after hospital discharge, 178 (32%) patients were readmitted to the hospital, with 45 (8%) readmitted more than once. Forty-seven of 233 readmissions (20%) occurred within the first 2 weeks after discharge, and 80 (34%) occurred within 4 weeks. Over 6 months, 89% of readmissions were for nonsurgical problems, of which infectious (21%) and cardiac (12%) diseases were the most common. In multivariate analyses, patients who were readmitted were more likely to require total assistance with ambulation at 6 months (odds ratio (OR) = 2.7, 95% confidence interval (CI) = 1.6-4.6) and to die (OR = 4.0, 95% CI = 2.2-7.3) than those not readmitted. CONCLUSION: Hospital readmissions after hip fracture are largely due to nonsurgical illness and are associated with increased morbidity and mortality.

KW - Disability

KW - Hip fractures

KW - Mortality

KW - Patient readmission

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