RISK FACTORS ASSOCIATED WITH HOSPITAL READMISSION IN PATIENTS WITH HIP FRACTURES IN POST-ACUTE REHABILITATION FACILITIES

Introduction: Periprosthetic hip fractures (PPFX) are serious complications that result in increased morbidity, mortality and healthcare costs. Decreasing hospital readmissions has been a recent healthcare focus, but little is known about the overall costs associated with PPFX or the risk factors associated with readmissions. We investigated patient demographics, treatment types, 30- and 90-day readmission rates, direct costs, and patient risk factors associated with PPFX readmission. Methods: We used the 2013 Nationwide Readmissions Database to select patients who underwent total hip arthroplasty (THA), revision THA, and PPFX treated with open reduction internal fixation (ORIF) or revision THA. Survival analysis was used to evaluate the 90-day all-cause hospital readmission rate, and risk factors were identified using a Cox proportional hazards model, adjusting for patient and hospital characteristics. Results: We identified 1269 patients with PPFX treated with ORIF and 3254 treated with revision THA. 90-day readmissions were 20.9% and 27.3%, respectively. Patients with PPFX were older, female, and had multiple medical comorbidities. Patient factors associated with increased risk of readmission include: age; comorbidities; and discharge to skilled nursing facility; Medicare or Medicaid insurance. Hospital factors associated with increased risk of readmission include: large hospitals; nonprofits; metropolitan and teaching hospitals. The cost of readmission for PPFX treated with ORIF was $17,206 and revision THA was $16,504. Discussion: Periprosthetic hip fractures have high rates of hospital readmission, implying a significant burden to the healthcare system. Identifying risk factors is an important step towards identifying treatment pathways that can improve outcomes.

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Hospital Readmission in Patients With COVID-19

10.21203/rs.3.rs-658872/v1 ◽

2021 ◽

Author(s):

Neda Rahimian ◽

Mahshid Heidari ◽

Nahid Hashemi-Madani ◽

Nader Tavakoli ◽

Moammad E Khamseh

Keyword(s):

Risk Factors ◽

Hospital Readmission ◽

Underlying Disease ◽

Control Groups ◽

Factors Associated ◽

Infection Age ◽

Discharge Plan ◽

Matched Case ◽

And Control ◽

Control Study

Abstract Objective: During the COVID-19 pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Method: This is a multicenter, case-control study included 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios. COVID-19 readmission rate was assessed. Moreover, Logistic regression analysis was applied to determine the factors associated with readmission. Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (IQR) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid (GC) were significantly associated with a higher rate of readmission (OR: 2.76, 95% CI :1.30- 5.87) and (OR:8.24, 95% CI :3.72- 18.22), respectively.Conclusion: Identification of Risk factors of COVID 19 readmission will improve resource utilization and patient care.

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Pharmacological risk factors associated with hospital readmission rates in a psychiatric cohort identified using prescriptome data mining

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-018-0653-3 ◽

2018 ◽

Vol 18 (S3) ◽

Cited By ~ 5

Author(s):

Khader Shameer ◽

M. Mercedes Perez-Rodriguez ◽

Roy Bachar ◽

Li Li ◽

Amy Johnson ◽

...

Keyword(s):

Risk Factors ◽

Data Mining ◽

Hospital Readmission ◽

Readmission Rates ◽

Factors Associated ◽

Hospital Readmission Rates

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Risk factors for acute psychiatric readmission

Psychiatric Bulletin ◽

10.1192/pb.21.10.600 ◽

1997 ◽

Vol 21 (10) ◽

pp. 600-603 ◽

Cited By ~ 9

Author(s):

Mandy Dixon ◽

Emma Robertson ◽

Mohan George ◽

Femi Oyebode

Keyword(s):

Risk Factors ◽

Hospital Readmission ◽

Readmission Rate ◽

Service Planning ◽

Living Alone ◽

Retrospective Case ◽

Psychiatric Readmission ◽

Factors Associated ◽

Hospital Readmission Rate ◽

Discharge Against Medical Advice

A retrospective case note study explored readmissions to an acute psychiatric in-patient unit within six months of discharge. The study aimed to calculate a hospital readmission rate, to investigate the timing of readmissions, and to identify risk factors associated with readmission. The readmission rate was 27% with the majority of readmissions occurring within three months after discharge, suggesting the need for investigation of such early readmissions. The three factors found to predict readmission were: discharge against medical advice, number of previous admissions, and living alone or with family rather than in care. Implications for hospital service planning are considered.

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Clostridium difficile colitis in patients undergoing surgery for hip fractures: an analysis of 17,474 patients

Hip International ◽

10.1177/1120700019831950 ◽

2019 ◽

Vol 30 (1) ◽

pp. 22-32

Author(s):

Azeem Tariq Malik ◽

Carmen E Quatman ◽

Laura S Phieffer ◽

Thuan V Ly ◽

Safdar N Khan

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Clostridium Difficile ◽

Hip Fractures ◽

Healthcare Utilisation ◽

Open Reduction Internal Fixation ◽

Fracture Repair ◽

Bundled Payment ◽

Factors Associated ◽

Incidence Risk

Background: We compiled evidence from a large national surgical database to identify the incidence, risk factors and postoperative impact of Clostridium difficile infection (CDI) in patients undergoing hip fracture repair. Methods: We identified 17,474 patients who underwent hip fracture repairs in 2015 using the ACS-NSQIP database. Interventions studied were open reduction/Internal fixation, total hip arthroplasty or hemiarthroplasty being performed for traumatic hip fractures. Outcomes studied were incidence, preoperative and postoperative risk factors for occurrence of CDI were studied using descriptive and statistical analysis. Results: A total of 92 patients (0.53%) developed CDI within 30 days of the operation. Following adjustment using multi-variate logistic regression, preoperative and hospital-associated factors associated with development of CDI were smoking (OR 1.75 [95% CI 1.03–2.99]), hypertension (OR 1.70 [95% CI 1.01–2.85]), hyponatraemia (OR 1.65 [95% CI 1.04–2.63]), prior systemic inflammatory response syndrome (SIRS) (OR 2.18 [95% CI 1.32-3.59]) and a length of stay >7 days (OR 1.98 [95% CI 1.11–3.53]. Postoperative factors associated with occurrence of CDI were occurrence of a deep surgical site infection (SSI) (OR 5.89 [95% CI 1.31–26.6]), a stay in the hospital >30 days (OR 6.56 [95% CI 2.56–16.9]) and unplanned reoperations (OR 2.78 [95% CI 1.29–5.99]). Conclusion: As we move toward an era of bundled-payment models, identification of risk factors associated with the occurrence of postoperative complications, such as CDI, will help curb excess healthcare utilisation and costs associated with the management of this complication.

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Analysis of Risk Factors Associated with Hospital Readmission Within 360 Days After Degenerative Lumbar Spine Surgery in Elderly Patients

World Neurosurgery ◽

10.1016/j.wneu.2019.01.293 ◽

2019 ◽

Vol 126 ◽

pp. e196-e207 ◽

Cited By ~ 2

Author(s):

Jong Joo Lee ◽

Seong Bae An ◽

Tae Woo Kim ◽

Dong Ah Shin ◽

Seong Yi ◽

...

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Elderly Patients ◽

Spine Surgery ◽

Hospital Readmission ◽

Lumbar Spine Surgery ◽

Factors Associated ◽

Degenerative Lumbar Spine ◽

Surgery In Elderly

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Iatrogenic risk factors associated with hospital readmission of elderly patients: A matched case-control study using a clinical data warehouse

Journal of Clinical Pharmacy and Therapeutics ◽

10.1111/jcpt.12670 ◽

2018 ◽

Vol 43 (3) ◽

pp. 393-400 ◽

Cited By ~ 2

Author(s):

C. Schwab ◽

V. Korb-Savoldelli ◽

J. B. Escudie ◽

C. Fernandez ◽

P. Durieux ◽

...

Keyword(s):

Risk Factors ◽

Data Warehouse ◽

Hospital Readmission ◽

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Clinical Data Warehouse ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01962-6 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Lili Yu ◽

Yanbin Zhu ◽

Wei Chen ◽

Hui Bu ◽

Yingze Zhang

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Hip Fractures ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Individual Risk ◽

Factors Associated ◽

Postoperative Stroke

Abstract Objectives Stroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures. Methods This was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke. Results During the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke. Conclusions Although most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind.

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