Abstract
Objectives
To investigate the effects of geriatric rehabilitation on short-term risk of death
and readmission after a hip fracture were investigated in a nationwide cohort. In
addition, the association of discharge location (nursing home or patient's home) with
the short-term risk of death was assessed.
Design, Setting, and Participants
The cohort consisted of 89,301 individuals at least 50 years of age, with a first
hip fracture registered in the Swedish quality register RIKSHÖFT, the years 2004–2012.
Measures
Short-term risk of death and readmission to hospital after discharge was compared
at 8 hospitals, where most patients received inpatient care in geriatric wards, and
those treated at 71 regular hospitals.
Results
The risks of death within 30 days of admission were 7.1% in patients admitted to geriatric
ward hospitals and 7.4% in those treated at regular hospitals (multivariable-adjusted
hazard ratio [HR] 0.91, 95% CI 0.85–0.97), whereas the odds of readmission within
30 days of discharge were 8.7% and 9.8%, respectively (multivariable-adjusted odds
ratio 0.86, 95% CI 0.81–0.91). The risk of death was influenced by discharge location
and inpatient length of stay (LOS). Thus, for patients discharged to short-term nursing
homes with a LOS of at most 10 days, each additional day of LOS reduction increased
the risk of death within 30 days of discharge by 13% (HR 1.13, 95% CI 1.08–1.18).
This association was reduced in patients discharged to permanent nursing homes (HR
1.04, 95% CI 1.02–1.07), and not significant in those discharged to their own home
(OR 1.00, 95% CI 0.91–1.10).
Conclusion
The risks of death and readmission were lower in patients with hip fracture who received
care in hospitals with geriatric wards. The risk of death after discharge increased
with shorter LOS, especially in patients discharged to short-term nursing homes.
Keywords
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Article info
Publication history
Published online: August 18, 2015
Footnotes
The authors declare no conflicts of interest.
The present study was funded by the Swedish Research Council (2011-2976). The work presented was made totally independent of the funder.
Identification
Copyright
© 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
