Higher Readmission Rates After Hip Fracture Among Patients With Vestibular Disorders.

Autor:	Curry SD; Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center., Carotenuto A; Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center., DeLuna DA; College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center., Maar DJ 2nd; College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center., Huang Y; College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center., Samson KK; Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center., Siebler JC; Department of Orthopaedic Surgery and Rehabilitation, 985640 Nebraska Medical Center, Omaha, Nebraska., Hatch JL; Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2021 Oct 01; Vol. 42 (9), pp. e1333-e1338.
DOI:	10.1097/MAO.0000000000003277
Abstrakt:	Objective: Falls in older adults are associated with high morbidity and mortality. Patients with vestibular disorders may have an increased risk. The purpose of this study was to examine the outcomes among patients with underlying vestibular disorders who have hip fractures and identify predictors of increased morbidity and mortality. Study Design: Retrospective cohort study. Setting: Tertiary care academic medical center. Patients: Two hundred one adults diagnosed with a vestibular disorder and hip fracture due to a ground-level fall were compared to 327 age- and sex-matched controls with fractures due to ground-level falls without vestibular diagnoses. Patients were treated between 2013 and 2019. Main Outcome Measures: Length of hospital stay, 30-day readmission rate, and 30-day mortality rate. Results: Thirty-day readmission rate after hip fracture was significantly increased in patients with vestibular disorders compared to matched controls (p < 0.001), odds ratio 3.12 (95% confidence interval 1.84-5.39). Reasons for readmission in the vestibular patient group included higher rates of repeat falls, infections, and recurrent vestibular symptoms. Use of medication classes associated with falls or hip fractures was not significantly different between groups, except for lower rates of antihypertensive use in the vestibular group (54.0% vs. 67.7%, p = 0.002). No significant difference was found for length of hospital stay (7.34 ± 4.95 vs. 8.14 ± 20.50 days, p = 0.51) or 30-day mortality rate (5.0% vs. 4.6%, p = 0.99). No significant differences were found between groups for age, sex, race, rate of surgical treatment for hip fracture, or disposition at discharge. Conclusions: Patients with vestibular disorders are at a significantly higher risk of hospital readmission within 30 days after discharge for treatment for hip fracture. Competing Interests: The authors disclose no funding and conflicts of interest. (Copyright © 2021, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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