Factors Affecting Mortality and Hospital Admissions after Hip Surgery among Elderly Patients with Hip Fracture in Hong Kong - Review of a Three-Year Follow-Up.
Apple Qiao-Ling Wang, Bobby Hin-Po Ng, Lydia Po-Chee Cheung and 1 others
PMID 30186075WHAT IT FOUND
Three years after hip fracture surgery, 33.4% of these older patients had died and 71.7% had been readmitted.
Male patients, delayed surgery, low albumin, cognitive impairment, and assisted walking or low discharge independence flagged higher risk.
Key findings
01Among 293 analysed patients, 33.4% had died and 71.7% had at least one emergency readmission by 3 years after hip fracture.
02Male sex, surgery delayed beyond 48 hours, and pre-operation albumin below 3.5 g/dl were associated with higher mortality at several follow-up intervals.
03Assisted walker or non-walker status was associated with higher first emergency readmission for most intervals, while discharge FIM below 90 and age over 80 were associated at selected intervals.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
All patients came from one hospital rehabilitation centre, so results may not generalise. The sample was relatively small compared with other observational studies, reducing power to detect some risk factors. Patients transferred back to acute hospital were excluded, and their number was not recorded, so mortality and readmission may be underestimated. Smoking and alcohol were not controlled for, although most deaths and admissions were medical. Time-to-event analysis was not used, even though dates were known.
The easy way to misread this
Do not read these factors as proven causes or as guaranteed targets for reducing death or readmission. This was a single-centre historical cohort, and the paper says further research is needed to see whether nutritional supplement affects mortality.