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. 2022 Feb 2:26:101785.
doi: 10.1016/j.jcot.2022.101785. eCollection 2022 Mar.

Prolonged hospital stay after arthroplasty for geriatric femoral neck fractures is associated with increased early mortality risk after discharge

Andrew M Schneider  1 , Carlos Mucharraz  1 , Steven Denyer  1 , Nicholas M Brown  1
Affiliations

Prolonged hospital stay after arthroplasty for geriatric femoral neck fractures is associated with increased early mortality risk after discharge

Andrew M Schneider et al. J Clin Orthop Trauma. .

Abstract

Background: Recent studies show increasing mortality rates of geriatric femoral neck fracture patients with delays in operative treatment greater than 48 hours from injury. A less extensively studied area in this population is the effect of length of inpatient hospital stay (LOS) on outcomes. The purpose of this study was to determine the association of LOS after arthroplasty for geriatric femoral neck fractures with 30-day mortality risk.

Methods: This study is a retrospective review using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), a nationally validated, outcomes-based database incorporating data from over 700 geographically diverse medical centers. It included 9005 patients, 65 years of age or older, who underwent either hemiarthroplasty or total hip arthroplasty for a femoral neck fracture between 2011 and 2018. Using multivariate analysis, risk of 30-day mortality based on surgery-to-discharge time was determined, expressed as odds ratios (OR) with 95% confidence intervals (CI).

Results: After controlling for sex, BMI, age, surgical procedure, American Society of Anesthesiologists (ASA) classification, and discharge location, the risk of mortality after discharge was increased with longer post-surgical length of stay [OR 2.5, P < .001].

Conclusion: Prolonged LOS after arthroplasty for geriatric femoral neck fractures is associated with increased 30-day mortality risk. Efforts made to target and mitigate modifiable risk factors responsible for delaying discharge may improve early outcomes in this population.

Keywords: Femoral neck fractures; Hip fractures; Length of stay; Mortality risk.

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Conflict of interest statement

The authors declare that there is no potential conflict of interest relevant to this article.

Figures

Fig. 1
Fig. 1
Impact of delay to surgery and delay to discharge on risk of 30-day mortality.
See this image and copyright information in PMC

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