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. 2025 Jun 22;35(1):266.
doi: 10.1007/s00590-025-04393-3.

Ready for discharge? Factors associated with prolonged length of stay following geriatric hip fracture

Christopher Pettit  1 , Carolyn Herbosa  1 , Abhishek Ganta  1   2 , Kenneth Egol  1   2 , Sanjit Konda  3   4
Affiliations

Ready for discharge? Factors associated with prolonged length of stay following geriatric hip fracture

Christopher Pettit et al. Eur J Orthop Surg Traumatol. .

Abstract

Purpose: To identify factors associated with prolonged length of stay following geriatric hip fractures.

Methods: A single-center retrospective study of a consecutive series of geriatric (age > 65) hip fractures between 10/1/14 and 11/1/23 was performed. Patient demographics, injury/surgery characteristics, and inpatient complications were reviewed. Patients who died during hospitalization were excluded. Patients were cohorted into "average" LOS (nLOS) and "prolonged" LOS (pLOS); pLOS was defined as 1 standard deviation above the mean LOS. Cohort variables were compared using standard statistical tests. Multivariable logistic regression was used to isolate covariates that were independently associated with pLOS while controlling for confounders.

Results: A total of 3383 patients were identified. Average LOS was 6.38 days (S.D. = 4.24 days), and prolonged LOS was 10.62 days. The pLOS cohort was sicker and less functionally independent at baseline. The pLOS cohort had a more complicated hospital course with a 6 × increase in major complications and 2 × increase in minor complications. The demographic characteristic associated the most to pLOS was male gender. The injury/surgery characteristic contributing the most to pLOS was time from admission to surgery. The complication contributing the most to pLOS was new-onset stroke.

Conclusion: Multiple demographic and outcome factors are associated with pLOS in geriatric hip fractures. While demographics cannot be changed, teams should focus on modifiable factors such as reducing time to surgery and identification, prevention, and treatment of perioperative complications, most importantly stroke and pneumonia, to prevent delays in discharge following hip fracture in the elderly population.

Level of evidence: Level IV.

Keywords: Demographics; Hip fracture; Post-operative complications; Prolonged length of stay; Time to surgery.

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Conflict of interest statement

Declarations. Conflict of interest: Dr. Konda is a consultant and receives royalties from Stryker, receives publishing royalties from Wolters Kluwer, is a committee member for the American Academy of Orthopaedic Surgeons. Dr. Egol is a consultant and receives royalties from Exactech, receives publishing royalties from Wolters Kluwer, receives research support from Acumed and Synthes. All other authors declare that they have no conflicts of interest related to the content of this manuscript. No sources of funding have been granted for this study.

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