30-day and one-year readmission rate in 11,270 patients with surgical treatment for proximal femoral fractures across Austria

Maria A Smolle; Stefan F Fischerauer; Ines Vukic; Lukas Leitner; Paul Puchwein; Harald Widhalm; Andreas Leithner; Patrick Sadoghi

doi:10.1302/2633-1462.54.BJO-2024-0002.R1

30-day and one-year readmission rate in 11,270 patients with surgical treatment for proximal femoral fractures across Austria

Bone Jt Open. 2024 Apr 11;5(4):294-303. doi: 10.1302/2633-1462.54.BJO-2024-0002.R1.

Authors

Maria A Smolle^{1

2}, Stefan F Fischerauer¹, Ines Vukic³, Lukas Leitner¹, Paul Puchwein¹, Harald Widhalm⁴, Andreas Leithner¹, Patrick Sadoghi¹

Affiliations

¹ Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
² Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
³ Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria.
⁴ Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.

PMID: 38599585
PMCID: PMC11007600
DOI: 10.1302/2633-1462.54.BJO-2024-0002.R1

Abstract

Aims: Patients with proximal femoral fractures (PFFs) are often multimorbid, thus unplanned readmissions following surgery are common. We therefore aimed to analyze 30-day and one-year readmission rates, reasons for, and factors associated with, readmission risk in a cohort of patients with surgically treated PFFs across Austria.

Methods: Data from 11,270 patients with PFFs, treated surgically (osteosyntheses, n = 6,435; endoprostheses, n = 4,835) at Austrian hospitals within a one-year period (January to December 2021) was retrieved from the Leistungsorientierte Krankenanstaltenfinanzierung (Achievement-Oriented Hospital Financing). The 30-day and one-year readmission rates were reported. Readmission risk for any complication, as well as general medicine-, internal medicine-, and surgery/injury-associated complications, and factors associated with readmissions, were investigated.

Results: The 30-day and one-year readmission rates due to any complication were 15% and 47%, respectively. The 30-day readmission rate (p = 0.001) was higher in endoprosthesis than osteosynthesis patients; this was not the case for the one-year readmission rate (p = 0.138). Internal medicine- (n = 2,273 (20%)) and surgery/injury-associated complications (n = 1,612 (14%)) were the most common reason for one-year readmission. Regardless of the surgical procedure, male sex was significantly associated with higher readmission risk due to any, as well as internal medicine-associated, complication. Advanced age was significantly associated with higher readmission risk after osteosynthesis. In both cohorts, treatment at mid-sized hospitals was significantly associated with lower readmission risk due to any complication, while prolonged length of stay was associated with higher one-year readmission risks due to any complication, as well as internal-medicine associated complications.

Conclusion: Future health policy decisions in Austria should focus on optimization of perioperative and post-discharge management of this vulnerable patient population.