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Factors Affecting Hospital Stay Duration in the Conservative Treatment of Patients With Osteoporotic Vertebral
Koshiro Shimasaki1,2, Kousei Miura3, Tomohiro Yoshizawa3
1Department of Orthopedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, JPN.
Introduction:
Our research question explores the factors contributing to the substantial variation in the length of hospital stay among patients receiving inpatient conservative treatment for osteoporotic vertebral fractures (OVFs). This study aimed to identify key determinants influencing hospitalization duration in this patient population.
Methods:
Overall, 187 patients admitted for conservative treatment of OVF at a single institution between April 2020 and March 2024 were retrospectively analyzed. Data on age, sex, Charlson Comorbidity Index (CCI), cognitive impairment, pre-injury mobility, cohabitation status, in-hospital complications, nutritional status, sarcopenia, discharge destination, and length of stay were obtained. A subgroup analysis was conducted to compare patients discharged home with those discharged to non-home settings.
Results:
Multiple regression analysis revealed that cognitive impairment, pre-injury mobility, cohabitation status, and in-hospital complications significantly influenced the length of stay. In the subgroup analysis, sex and cognitive impairment were significant in the univariate analysis, whereas cognitive function remained significant in the multivariate analysis.
Conclusions:
Inpatients with OVFs undergoing conservative treatment had a significantly longer length of stay if they had cognitive impairment, lower pre-injury mobility, lived alone, or experienced hospitalization-related complications. Patients with cognitive impairment were less likely to be discharged home but more likely to be discharged to non-home settings, including care facilities. Early intervention by a multidisciplinary team targeting these factors can increase home-discharge rates, reduce length of stay, lower medical costs, and extend healthy life expectancy.
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