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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 222-230
DOI: 10.1055/s-0043-1768624
Artigo Original | Original Article
Trauma

Factors Associated with Readmission within 30 Days after Discharge and In-Hospital Mortality after Proximal Femoral Fracture Surgery in the Elderly: Retrospective Cohort[*]

Article in several languages: português | English
Alex Fabiano Dias Pinto 
1   Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
,
Clarissa Moreira Teatini 
1   Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
,
Núbia Carelli Pereira de Avelar 
2   Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina. Araranguá, SC, Brasil
,
Amanda Aparecida Oliveira Leopoldino 
2   Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina. Araranguá, SC, Brasil
,
Isabel Cristina Gomes Moura 
3   Programa de Pós-Graduação em Ciências da Saúde, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
› Author Affiliations Financial Support This study did not receive any financial support from either public, commercial, or not-for-profit sources.
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Abstract

Objective To evaluate the factors associated with readmission within 30 days after discharge (R30) and in-hospital mortality (IHM) in elderly patients undergoing proximal femur fracture surgery (PFF).

Methods Retrospective cohort with data from 896 medical records of elderly (≥ 60 years) patients submitted to PFF surgery in a Brazilian hospital between November 2014 and December, 2019. The patients included were followed-up from the date of hospitalization for surgery up to 30 days after discharge. As independent variables, we evaluated gender, age, marital status, pre- and postoperative hemoglobin (Hb), international normalized ratio, time of hospitalization related to the surgery, door-surgery time, comorbidities, previous surgeries, use of medications, and the American Society of Anesthesiologists (ASA) score.

Results The incidence of R30 was 10.2% (95% confidence interval [CI]: 8.3–12.3%), and the incidence of IHM was 5.7% (95%CI: 4.3–7.4%). Regarding R30, hypertension (odds ratio [OR]: 1.71; 95%CI: 1.03–2.96), and regular use of psychotropic drugs (OR: 1.74; 95%CI: 1.12–2.72) were associated in the adjusted model. In the case of IHM, higher chances were associated with chronic kidney disease (CKD) (OR: 5.80; 95%CI: 2.64–12.31), longer hospitalization time (OR: 1.06; 95%CI: 1.01–1.10), and R30 (OR: 3.60; 95%CI: 1.54–7.96). Higher preoperative Hb values were associated with a lower chance of mortality (OR: 0.73; 95%CI: 0.61–0.87).

Conclusion Findings suggest that the occurrence of these outcomes is associated with comorbidities, medications, and Hb.

Keywords

aged - femoral fractures - patient readmission - mortality

* Work developed at the Department of Health Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.




Publication History

Received: 18 February 2022

Accepted: 18 October 2022

Article published online:
25 May 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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