Frailty, length of stay and cost in hip fracture patients

被引：31

作者：

Wong, Beatrix Ling Ling ^{[1
]}

Chan, Yiong Huak ^{[2
]}

O'Neill, Gavin Kane ^{[3
]}

Murphy, Diarmuid ^{[3
]}

Merchant, Reshma Aziz ^{[1
,4
]}

机构：

[1] Natl Univ Singapore Hosp, Dept Med, Div Geriatr Med, 1E Kent Ridge Rd, Singapore 119228, Singapore

[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Biostat Unit, 10 Med Dr, Singapore 117597, Singapore

[3] Natl Univ Singapore Hosp, Dept Orthopaed Surg, 1E Kent Ridge Rd, Singapore 119228, Singapore

[4] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, 10 Med Dr, Singapore 117597, Singapore

来源：

OSTEOPOROSIS INTERNATIONAL | 2023年 / 34卷 / 01期

基金：

英国科研创新办公室;

关键词：

Frailty; Healthcare cost; Hip fracture; Length of stay; Multimorbidity; MORTALITY; CARE; MANAGEMENT; SURGERY; INDEX;

D O I：

10.1007/s00198-022-06553-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：59 / 68

页数：10

共 45 条

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