Patient factors including AMTS <8, ASA grade ≥3, and inability to mobilize unaided independently increased acute hospital length of stay by 8.9, 4.2, and 20.4 days, respectively.
Observational (n=330)
Yes
What independent patient factors affect acute hospital and total health service length of stay following hip fractures?
ASA grade ≥3, AMTS <8, and poor mobility are independent predictors of significantly increased length of hospital stay following hip fracture.
Effect estimate: MD 8.9 days (AMTS <8), 4.2 days (ASA ≥3), 20.4 days (unable to mobilise unaided)
Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.
Richards et al. (Wed,) conducted a observational in hip fractures (n=330). Patient factors (ASA grade ≥3, AMTS <8, poor mobility) vs. Patients without these factors (e.g., independently mobile) was evaluated on Acute hospital and total hospital length of stay (MD 8.9 days (AMTS <8), 4.2 days (ASA ≥3), 20.4 days (unable to mobilise unaided)). Patient factors including AMTS <8, ASA grade ≥3, and inability to mobilize unaided independently increased acute hospital length of stay by 8.9, 4.2, and 20.4 days, respectively.