Missing the first post-operative visit is an independent risk factor for 90-day complication and re-admission following hip fracture surgery

Adam Michael Schlauch; Ishan Shah; Maria Caicedo; Oluwatodimu Richard Raji; Brian Farrell

doi:10.1016/j.jor.2022.12.004

Missing the first post-operative visit is an independent risk factor for 90-day complication and re-admission following hip fracture surgery

J Orthop. 2022 Dec 10:36:7-10. doi: 10.1016/j.jor.2022.12.004. eCollection 2023 Feb.

Authors

Adam Michael Schlauch¹, Ishan Shah¹, Maria Caicedo², Oluwatodimu Richard Raji², Brian Farrell³

Affiliations

¹ San Francisco Orthopaedic Residency Program, 450 Stanyan Street, San Francisco, CA, 94117, USA.
² The Taylor Collaboration, 2255 Hayes St, San Francisco, CA, 94117, USA.
³ Kaiser Permanente, 3600 Broadway, Oakland, CA, 94611, USA.

Abstract

Introduction: Knowing the risk factors for poor outcomes following hip fracture surgery is necessary for appropriate patient care. The objective of this study was to determine if the first post-operative visit (POV) following hip fracture surgery is a risk factor for increased mortality, complications, and re-admissions.

Methods: This was a retrospective review of 285 patients who underwent operative fixation of a hip fracture at an academic acute care hospital. Outcome measurements were 90-day and one year mortality, 90-day complications, and 90-day re-admission rates in patients who missed or attended their first post-operative visit following hip fracture surgery.

Results: 279 patients met inclusion criteria and had sufficient data for analysis, of which 213 (76.3%) made their first post-operative visit. 90-day and one-year mortality were significantly higher in the patients who missed their first POV (31.8% vs. 4.2%; 51.5% vs. 12.7%). Independent risk factors for 90-day complications were missing the first POV, coronary artery disease, and lower pre-injury status (ORs = 10.65, 2.80, 7.89, respectively). Independent risk factors for 90-day re-admission were missing the first POV, chronic obstructive pulmonary disease on home oxygen, and lower re-injury status (ORs = 8.04, 5.44, 5.47, respectively).

Conclusion: Missing the first POV was the strongest independent risk factor for 90-day complications and 90-day readmission. Patients who miss their first POV have significantly higher 90-day and one year mortality rates.

Keywords: Geriatric; Hip fracture; Post-operative care; Post-operative complications; Trauma.