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Patients with Osteoporotic Hip Fractures: Factors Affecting Length of Hospital Stay (LOS) and Outcome

Manee Raksakietisak MD*, Angkana Lurngnateetape MD*, Kongkhet Riansuwan MD**, Ninkan Noiwan MD*, Chutimart Chaiyarak MD*, Kittiya Keawmoon MD*, Benno von Bormann MD*

Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Orthopedics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand


Objective : Identify risk factors associated with prolonged hospital stay (LOS more than 14 days) in patients with osteoporotic hip fracture. Material and Method: One hundred and fi fty out of 356 patients with fractured femur were selected between April 2008 and August 2009. Analysis of patient’s LOS (group I equal or less than 14 days, group II more than 14 days) is performed by backward binary multiple logistic regression.
Results : LOS in group I (n = 46) was 12.5( 4) days compared to 21 ( 11) days in group II (n = 104). Patients were mainly female (74%) and about 50% were aged over 80 years. The 30-days mortality in group I and II was zero and two patients respectively. Time-to-surgery was three days ( 2) in group I and seven ( 5) days in group II. Signifi cant predicting risk factors were waiting for investigation (odds ratio (OR) 3.77, confi dence interval (CI) 1.12-12.69) and receiving systemic opioids (OR 3.44; CI 1.54-7.66).
Conclusion : Unnecessary surgery delay after hip fracture should be avoided. Higher need for opioids in those patients might be the result of prolonged waiting for surgical treatment.

Keywords : Hip fracture, Length of hospital stay (LOS), Time-to-surgery, Risk factors, Systemic opioids


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MEDICAL ASSOCIATION OF THAILAND
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