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Predictors of hospital readmission after fractures: One-year follow-up study
Lara Cristina da Cunha Guimarães1, Brenda Kelly Gonçalves Nunes1, Brunna Rodrigues de Lima1
1State School of Public Health Candido Santiago, State Department of Health of Goiás, Goiânia, Goiás, Brazil.
Objective:
Identify the incidence and predictive factors for readmissions of elderly hospitalized with fractures.
Method:
Prospective cohort study on 376 elderly people from a trauma referral large hospital in central Brazil. Data were collected from medical records of elderly people with radiological diagnosis of fractures. Readmission that occurs up to one year after the first discharge was defined the outcome variable. Pre- and post-admission characteristics were analyzed as predictive factors. Multiple analysis was performed using robust Poisson regression.
Results:
The main cause of hospitalization was fracture of the femur (53.2%) and the most frequent trauma mechanism was fall from standing height (72.9%). The incidence of readmission was 20.7%, of which 30.5% were related to the fracture itself, with emphasis on Surgical Site Infection. The predictors of readmissions were: age range 60 to 69 years, COPD, delirium and fracture of the femur.
Conclusions:
The incidence of readmissions was high, with various causes and associated conditions pre-admission (age range 60-69, presenting COPD) and post-admission (delirium). The monitoring of these factors in the hospital environment is essential for prevention of readmissions.
