Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Smolle, MA; Fischerauer, SF; Vukic, I; Leitner, L; Puchwein, P; Widhalm, H; Leithner, A; Sadoghi, P.
30-day and one-year readmission rate in 11,270 patients with surgical treatment for proximal femoral fractures across Austria.
Bone Jt Open. 2024; 5(4): 294-303.
Doi: 10.1302/2633-1462.54.BJO-2024-0002.R1
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- Führende Autor*innen der Med Uni Graz
- Puchwein Paul
- Smolle Maria Anna
- Co-Autor*innen der Med Uni Graz
- Fischerauer Stefan Franz
- Leithner Andreas
- Leitner Lukas
- Sadoghi Patrick
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- Abstract:
- AIMS: Patients with proximal femoral fractures (PFFs) are often multimorbid, thus unplanned readmissions following surgery are common. We therefore aimed to analyze 30-day and one-year readmission rates, reasons for, and factors associated with, readmission risk in a cohort of patients with surgically treated PFFs across Austria. METHODS: Data from 11,270 patients with PFFs, treated surgically (osteosyntheses, n = 6,435; endoprostheses, n = 4,835) at Austrian hospitals within a one-year period (January to December 2021) was retrieved from the Leistungsorientierte Krankenanstaltenfinanzierung (Achievement-Oriented Hospital Financing). The 30-day and one-year readmission rates were reported. Readmission risk for any complication, as well as general medicine-, internal medicine-, and surgery/injury-associated complications, and factors associated with readmissions, were investigated. RESULTS: The 30-day and one-year readmission rates due to any complication were 15% and 47%, respectively. The 30-day readmission rate (p = 0.001) was higher in endoprosthesis than osteosynthesis patients; this was not the case for the one-year readmission rate (p = 0.138). Internal medicine- (n = 2,273 (20%)) and surgery/injury-associated complications (n = 1,612 (14%)) were the most common reason for one-year readmission. Regardless of the surgical procedure, male sex was significantly associated with higher readmission risk due to any, as well as internal medicine-associated, complication. Advanced age was significantly associated with higher readmission risk after osteosynthesis. In both cohorts, treatment at mid-sized hospitals was significantly associated with lower readmission risk due to any complication, while prolonged length of stay was associated with higher one-year readmission risks due to any complication, as well as internal-medicine associated complications. CONCLUSION: Future health policy decisions in Austria should focus on optimization of perioperative and post-discharge management of this vulnerable patient population.