Are We Getting Better? Trends in 30-Day Readmission and Length of Stay Following Hip Fracture Surgery Among Older Adults: A Five-Year ACS-NSQIP Analysis.

PURPOSE: To examine five-year trends in 30-day readmission and length of stay (LOS) among the geriatric population after surgical fixation for hip fracture in a large database model. METHODS: Patients ≥ 65 years of age in the American College of Surgeons National Surgical Quality Improvement Program Targeted Hip Fracture (ACS-NSQIP THF) were identified using Current Procedural Terminology (CPT®) codes 27 236, 27 244, 27 245 for intramedullary nailing or Open Reduction and Internal Fixation (ORIF) of fractures involving the femoral head, neck, peritrochanteric, intertrochanteric, and subtrochanteric regions. The primary outcome was incidence of ≥1 30-day hospital readmission and secondary outcome was total hospital length of stay in trend analysis. RESULTS: Overall, there were 64 794 patients who met inclusion criteria, of which 7.85% (95% CI: 7.64% to 8.05%) were readmitted within 30 days of hip fracture surgical fixation. The proportion of patients with ≥1 30-day readmission were presented over time and Cochran-Armitage Trend Testing indicated a statistically significant decreasing trend in the 30-day readmission incidence from 2016-2021 (P < 0.0001). The mean absolute change in incidence from year-to-year was -0.24% (mean relative change, 0.97) and the total absolute difference in incidence from 2016 to 2021 was -1.20% (relative difference, 0.85). LOS data were missing for 1048 cases (1.62%). Mean and median length of stay data was similar across all years. CONCLUSION: The probability of having ≥1 30-day readmission decreased 0.85-times from 2016 to 2021, with a statistically significant downward trend over time. There were no meaningful changes in length of stay. Healthcare providers, policymakers, and stakeholders can utilize these findings to implement initiatives that enhance value-based care in hip fracture management and benchmark institutional metrics, ultimately improving patient outcomes and optimizing healthcare resources.

Duke Scholars

Author Christian Pean Orthopaedic Surgery

Author Malcolm R DeBaun Orthopaedic Surgery