Frailty, length of stay and cost in hip fracture patients.

Autor:	Wong, Beatrix Ling Ling, Chan, Yiong Huak, O'Neill, Gavin Kane, Murphy, Diarmuid, Merchant, Reshma Aziz
Předmět:	LENGTH of stay in hospitals PNEUMONIA FRAIL elderly ACADEMIC medical centers CONFIDENCE intervals POLYPHARMACY PRESSURE ulcers WOUND infections URINARY tract infections MEDICAL care costs HIP fractures PATIENT readmissions RETROSPECTIVE studies HEALTH status indicators REGRESSION analysis HOSPITAL mortality TREATMENT effectiveness RISK assessment OSTEOPOROSIS PSYCHOLOGICAL tests DESCRIPTIVE statistics DEMENTIA DELIRIUM DATA analysis software ODDS ratio RETENTION of urine LONGITUDINAL method COMORBIDITY BONE fractures DISEASE complications OLD age
Zdroj:	Osteoporosis International; Jan2023, Vol. 34 Issue 1, p59-68, 10p, 3 Charts, 1 Graph
Abstrakt:	Summary: A hip fracture causes high morbidity and mortality. Frailty is associated with adverse outcomes and increased costs. Frailty measured using the Hospital Frailty Risk Score (HFRS) is associated with higher costs and adverse outcomes. HFRS is useful as a fuss-free frailty measurement in the management of older adults with hip fractures. Introduction: Hip fractures account for an increasing number of hospital admissions around the world and are associated with high rates of morbidity and mortality. Frailty is increasingly recognized to be associated with adverse outcomes and increased costs. The purpose of this study is to determine the association of the Hospital Frailty Risk Score (HFRS) with the healthcare cost and outcomes in older adults who present with a hip fracture. Methods: A retrospective analysis was performed on 1014 patients ≥ 60 years who presented with a hip fracture between January 2016 to June 2020. Each patient was classified into HFRS low, intermediate or high frailty cohorts. Demographics, hip fracture type, comorbidities, Charlson Comorbidity Index (CCI), American Society of Anesthesiologist score (ASA), costs, length of stay, time to surgery, complications, readmission rate and mortality were compared between the cohorts. Results: Median total hospitalization costs were significantly higher in the highest HFRS (SGD$22,432) patients as compared to intermediate (SGD$18,759) and low HFRS (SGD$15,671) patients. The difference between the high and low groups remains significant after adjusting for covariates using quantile regression. Similar results were shown for median length of stay (14 vs 10 vs 8 days), total number of complications (2 vs 1 vs 0) and adjusted time to surgery (p < 0.05). HFRS was not associated with 30-day readmission or 30-day or 1-year mortality. Conclusion: Frailty is associated with a marked increase in total costs in hip fracture patients. HFRS proved useful in estimating LOS and outcomes for older patients with hip fractures. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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