Health Outcomes of Older Adults after a Hospitalization for a Hip Fracture

Authors

  • Cameron MacLellan Horizon Health Network New Brunswick; Dalhousie University
  • Karla Faig Horizon Health Network New Brunswick
  • Loren Cooper Dalhousie Medicine New Brunswick
  • Susan Benjamin Trauma New Brunswick
  • Joshua Shanks Dalhousie Medicine New Brunswick
  • Andrew J. Flewelling Horizon Health Network New Brunswick
  • Daniel J. Dutton Dalhousie University
  • Chris McGibbon University of New Brunswick
  • Alanna Bohnsack Dalhousie Medicine New Brunswick
  • James Wagg Dalhousie Medicine New Brunswick
  • Pamela Jarrett Dalhousie Medicine New Brunswick

DOI:

https://doi.org/10.5770/cgj.27.720

Keywords:

Seniors, Hospital stay, Length of stay, Mortality, Alternate level of care, Time to surgery

Abstract

Background

Hip fractures in older adults often lead to adverse health outcomes, which may be related to time to surgery and longer hospital stays. The experience of older adults with hip fractures in New Brunswick is not known.

Methods

This was a retrospective observational study. All hip fracture patients 65 years of age and older admitted to one hospital designated as a Level One Trauma Centre between April 1, 2015 and March 31, 2019 comprised the sample.

Results

The majority (86.5%) received surgery within 48 hours and those who had surgery beyond this time frame had a significantly longer stay in acute care (OR: 3.79, 95% CI: 2.05-7.15). The mean total length of stay (Total-LOS) for patients discharged after their acute care needs were met was 9.8 days (SD=8.1) compared to patients experiencing delays in discharge for nonmedical reasons which was 26.3 days (SD=33.7). An extended stay in acute care (OR: 1.93, 95% CI: 1.09-3.43) and increasing age (OR: 1.03, 95% CI: 1.001-1.06) were associated with a higher likelihood of death at one year post-discharge. Time to surgery beyond 24 hours (OR: 2.80, 95% CI: 1.13-7.38) was associated with a higher likelihood of death 30 days post-discharge.

Conclusions

Most patients had surgery within the national benchmark of less than 48 hours. The Total-LOS increased 2.5-fold in patients who remained in hospital after their acute care needs were met. A better understanding of patient characteristics, such as frailty, may better predict patients at risk for longer hospital stays and adverse health outcomes. 

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Published

2024-09-04

How to Cite

1.
MacLellan C, Faig K, Cooper L, Benjamin S, Shanks J, Flewelling AJ, Dutton DJ, McGibbon C, Bohnsack A, Wagg J, Jarrett P. Health Outcomes of Older Adults after a Hospitalization for a Hip Fracture . Can Geriatr J [Internet]. 2024 Sep. 4 [cited 2024 Nov. 6];27(3):290-8. Available from: https://cgjonline.ca/index.php/cgj/article/view/720

Issue

Section

Original Research