TY - JOUR
T1 - In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures
T2 - An Analysis of the Texas Trauma Registry
AU - Martinez, Victor H.
AU - Quirarte, Jaime A.
AU - Treffalls, Rebecca N.
AU - McCormick, Sekinat
AU - Martin, Case W.
AU - Brady, Christina I.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background: In-hospital mortality and discharge disposition following traumatic hip fractures previously reported in the literature, has mainly focused on a nationwide scale, which may not be reflective of unique populations. Objective: Our aim was to characterize demographics, hospital disposition, and associated outcomes for patients with the most common hip fractures. Methods: A retrospective study utilizing the Trauma Registry from the Texas Department of State Health Services. Patient demographics, injury characteristics, and outcomes, such as in-hospital mortality, and discharge dispositions, were collected. The data were analyzed via univariate analysis and multivariate regressions. Results: There were 17,104 included patients, composed of 45% femoral neck fractures (FN) and 55% intertrochanteric fractures (IT). There were no differences in injury severity score (ISS) (9 ± 1.8) or age (77.4 ± 8 years old) between fracture types. In-hospital mortality risk was low but different among fracture types (intertrochanteric, 1.9% vs femoral neck, 1.3%, P =.004). However, when controlling for age, and ISS, intertrochanteric fractures and Hispanic patients were associated with higher mortality (P <.001, OR 1.5, 95% CI 1.1-2.0). Uninsured, and Black/African American (P =.05, OR 1.2, 95% CI 1.1-1.3) and Hispanic (P <.001, OR 1.2, 95% CI 1.1-1.3) patients were more likely to be discharged home after adjusting for age, ISS, and payment method. Conclusion: Regardless of age, severity of the injury or admission hemodynamics, intertrochanteric fractures and Hispanic/Latino patients had an increased risk of in-hospital mortality. Patients who were uninsured, Hispanic, or Black were discharged home rather than to rehabilitation, regardless of age, ISS, or payment method.
AB - Background: In-hospital mortality and discharge disposition following traumatic hip fractures previously reported in the literature, has mainly focused on a nationwide scale, which may not be reflective of unique populations. Objective: Our aim was to characterize demographics, hospital disposition, and associated outcomes for patients with the most common hip fractures. Methods: A retrospective study utilizing the Trauma Registry from the Texas Department of State Health Services. Patient demographics, injury characteristics, and outcomes, such as in-hospital mortality, and discharge dispositions, were collected. The data were analyzed via univariate analysis and multivariate regressions. Results: There were 17,104 included patients, composed of 45% femoral neck fractures (FN) and 55% intertrochanteric fractures (IT). There were no differences in injury severity score (ISS) (9 ± 1.8) or age (77.4 ± 8 years old) between fracture types. In-hospital mortality risk was low but different among fracture types (intertrochanteric, 1.9% vs femoral neck, 1.3%, P =.004). However, when controlling for age, and ISS, intertrochanteric fractures and Hispanic patients were associated with higher mortality (P <.001, OR 1.5, 95% CI 1.1-2.0). Uninsured, and Black/African American (P =.05, OR 1.2, 95% CI 1.1-1.3) and Hispanic (P <.001, OR 1.2, 95% CI 1.1-1.3) patients were more likely to be discharged home after adjusting for age, ISS, and payment method. Conclusion: Regardless of age, severity of the injury or admission hemodynamics, intertrochanteric fractures and Hispanic/Latino patients had an increased risk of in-hospital mortality. Patients who were uninsured, Hispanic, or Black were discharged home rather than to rehabilitation, regardless of age, ISS, or payment method.
KW - III
KW - Texas
KW - discharge disposition
KW - hip fracture
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85170579329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85170579329&partnerID=8YFLogxK
U2 - 10.1177/21514593231200797
DO - 10.1177/21514593231200797
M3 - Article
C2 - 37701926
AN - SCOPUS:85170579329
SN - 2151-4585
VL - 14
JO - Geriatric Orthopaedic Surgery and Rehabilitation
JF - Geriatric Orthopaedic Surgery and Rehabilitation
ER -