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Several patient factors may increase length of stay after femur fracture treatment
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Patients with femur fractures may experience a shorter hospital length of stay with earlier fixation and aggressive management of medical complications, according to results published in The Journal of Orthopaedic Trauma.
Mara L. Schenker, MD, and colleagues categorized 321 patients who underwent operative treatment for femur fractures between July 2015 and July 2016 into groups as to whether their hospital length of stay was 6 days or more or was fewer than 6 days. Treatment methods included intramedullary nailing, open reduction and internal fixation, arthroplasty or other definitive fixation of femur fracture. Investigators used hospital length of stay as the primary outcome measure.
Results showed patients had a median length of stay of 6.43 days. According to results of the univariate analysis, extended length of stay was associated with several preoperative, perioperative and postoperative factors. Multivariate analysis showed independent predictors of length of stay included frailty, medical complications, an upper extremity injury, an ipsilateral lower extremity injury, time to definitive fixation, time to first physical therapy visit and injury severity score. Researchers also found an association between a fixation time of 24 hours or greater with increased age, decreased Glasgow Coma Scale, blunt injury mechanism, open femur fracture and ICU days. First physical therapy visit at 24 hours or more was also associated with decreased Glasgow Coma Scale, increased injury severity score, blunt injury type and increased ICU days.
“Identification of patients who are at high-risk for increased hospital length of stay after orthopedic injuries is imperative for cost containment,” Schenker told Healio.com/Orthopedics. “Medical issues, including underlying frailty, as well as complications that arose during hospitalization, led to the highest odds of increased [length of stay] LOS. Interdisciplinary management of patients with medical comorbidities may improve this over time.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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