Tackling the challenge of 90-day readmissions in hip fracture management: a retrospective study

Prajwal A. Srinivasan; Vinayak Venugopal; Raam M. Selvarajan; Satish Dhotare; Ranusha Ganapathy; Shiv Patel; Muhammad Tariq; Omar Mahmoud

doi:10.18203/issn.2455-4510.IntJResOrthop20243111

Authors

Prajwal A. Srinivasan Whiston Hospital, Mersey west Lancashire NHS trust, UK
Vinayak Venugopal Whiston Hospital, Mersey west Lancashire NHS trust, UK
Raam M. Selvarajan Whiston Hospital, Mersey west Lancashire NHS trust, UK
Satish Dhotare Whiston Hospital, Mersey west Lancashire NHS trust, UK
Ranusha Ganapathy Whiston Hospital, Mersey west Lancashire NHS trust, UK
Shiv Patel Whiston Hospital, Mersey west Lancashire NHS trust, UK
Muhammad Tariq Department of Elderly Medicine, Whiston Hospital, Mersey west Lancashire NHS trust, UK
Omar Mahmoud Whiston Hospital, Mersey west Lancashire NHS trust, UK

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243111

Keywords:

Hip fracture, Readmission, Orthopaedics, Retrospective study, Management strategies, NOF fracture, Healthcare burden

Abstract

Background: Hip fracture readmissions within 90 days pose a significant challenge in orthopaedics, burdening healthcare systems and affecting patient outcomes. This study, set against the backdrop of an aging population and rising hip fracture incidences, seeks to analyse the factors contributing to these readmissions and propose viable management strategies.

Methods: Conducted as a single centre study at a hospital which is part of the NHS UK, this retrospective study reviewed 1264 patients treated for neck of femur (NOF) fractures between April 2020 and December 2022. Data on patient demographics, comorbidities, surgical interventions, and readmission reasons were collected and analysed using descriptive statistics and multivariable logistic regression.

Results: The study found a 21.8% readmission rate, with the majority being for non-orthopaedic reasons such as infections and cardiovascular events. Age and comorbidities were significant predictors of readmission, while surgical factors had a less pronounced impact. A year-wise trend showed a peak in readmissions during the COVID-19 pandemic.

Conclusions: The findings emphasize the complexity of managing NOF fractures and the importance of a comprehensive, multidisciplinary approach to care. Targeted interventions, including orthogeriatric co-management and falls assessment, are recommended to mitigate readmission risks and enhance patient care, though further research is needed for more definitive strategies.

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