Faculty Collaboration Database

Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient's Hospital Length of Stay? J Orthop Trauma 2016 Feb;30(2):95-9

Date

09/16/2015

Pubmed ID

26371621

Pubmed Central ID

PMC4841672

DOI

10.1097/BOT.0000000000000440

Scopus ID

2-s2.0-84956585386 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

OBJECTIVES: The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient.

DESIGN: Retrospective.

SETTING: Urban level 1 trauma center.

PATIENTS/PARTICIPANTS: Six hundred fourteen geriatric hip fracture patients from 2000 to 2009.

INTERVENTIONS: Orthopaedic surgery for geriatric hip fracture.

MAIN OUTCOME MEASUREMENTS: Patient demographics, medical comorbidities, hospitalization length, and admitting service. Negative binomial regression used to determine association between LOS and admitting service.

RESULTS: Six hundred fourteen geriatric hip fracture patients were included in the analysis, of whom 49.2% of patients (n = 302) were admitted to the orthopaedic service and 50.8% (3 = 312) to the medicine service. The median LOS for patients admitted to orthopaedics was 4.5 days compared with 7 days for patients admitted to medicine (P < 0.0001). Readmission was also significantly higher for patients admitted to medicine (n = 92, 29.8%) than for those admitted to orthopaedics (n = 70, 23.1%). After controlling for important patient factors, it was determined that medicine patients are expected to stay about 1.5 times (incidence rate ratio: 1.48, P < 0.0001) longer in the hospital than orthopaedic patients.

CONCLUSIONS: This is the largest study to demonstrate that admission to the medicine service compared with the orthopaedic service increases a geriatric hip fractures patient's expected LOS. Since LOS is a major driver of cost as well as a measure of quality care, it is important to understand the factors that lead to a longer hospital stay to better allocate hospital resources. Based on the results from our institution, orthopaedic surgeons should be aware that admission to medicine might increase a patient's expected LOS.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Author List

Greenberg SE, VanHouten JP, Lakomkin N, Ehrenfeld J, Jahangir AA, Boyce RH, Obremksey WT, Sethi MK

Author

Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Admitting Department, Hospital
Age Distribution
Aged
Aged, 80 and over
Female
Health Services for the Aged
Hip Fractures
Humans
Length of Stay
Male
Middle Aged
Orthopedics
Patient Admission
Prevalence
Sex Distribution
Tennessee