30-day and one-year readmission rate in 11,270 patients with surgical treatment for proximal femoral fractures across Austria

BONE & JOINT OPEN(2024)

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摘要
Aims Patients with proximal femoral fractures (PFFs) are often multimorbid, thus unplanned readmissions following surgery are common. We therefore aimed to analyze 30 -day and one-year readmission rates, reasons for, and factors associated with, readmission risk in a cohort of patients with surgically treated PFFs across Austria. Methods Data from 11,270 patients with PFFs, treated surgically (osteosyntheses, n = 6,435; endoprostheses, n = 4,835) at Austrian hospitals within a one-year period (January to December 2021) was retrieved from the Leistungsorientierte Krankenanstaltenfinanzierung (AchievementOriented Hospital Financing). The 30 -day and one-year readmission rates were reported. Readmission risk for any complication, as well as general medicine-, internal medicine-, and surgery/injury-associated complications, and factors associated with readmissions, were investigated. Results The 30 -day and one-year readmission rates due to any complication were 15% and 47%, respectively. The 30 -day readmission rate (p = 0.001) was higher in endoprosthesis than osteosynthesis patients; this was not the case for the one-year readmission rate (p = 0.138). Internal medicine- (n = 2,273 (20%)) and surgery/injury-associated complications (n = 1,612 (14%)) were the most common reason for one-year readmission. Regardless of the surgical procedure, male sex was significantly associated with higher readmission risk due to any, as well as internal medicine -associated, complication. Advanced age was significantly associated with higher readmission risk after osteosynthesis. In both cohorts, treatment at mid -sized hospitals was significantly associated with lower readmission risk due to any complication, while prolonged length of stay was associated with higher one-year readmission risks due to any complication, as well as internal -medicine associated complications. Conclusion Future health policy decisions in Austria should focus on optimization of perioperative and post -discharge management of this vulnerable patient population.
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关键词
proximal femoral fracture,readmission,healthcare policy,endoprosthetic replacement,osteosynthesis,complication,proximal femoral fractures,surgical treatment,osteosyntheses,endoprosthesis,arthroplasties,chi-squared tests,logistic regression models,comorbidities,hip hemiarthroplasties,femoral neck fractures
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