Low-volume hospitals had increased complication rates among peritrochanteric hip fractures
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Surgical management of peritrochanteric hip fractures at low-volume hospitals yielded increased rates of mortality, readmission and certain complications compared with those managed at high-volume hospitals, according to published results.
“Our results demonstrated increased rates of mortality, readmission and certain complications, namely pneumonia and wound complications, when surgeries were performed at low-volume facilities relative to high-volume facilities. Interestingly, relatively few differences were noted when evaluating complication rates between high-volume and low-volume surgeons,” Edward J. Testa, MD, told Healio. “These results are important for surgeons and hospitals alike to understand moving forward as we seek to optimize patient outcomes after common orthopedic surgeries treated at institutions and by providers who may vary in experience with such surgeries.”
Using the New York Statewide Planning and Research Cooperative System database, Testa and colleagues compared readmission, reoperations, in-hospital mortality and other adverse events across surgeon and facility volumes among 29,656 patients who underwent surgical fixation for closed peritrochanteric hip fractures from 2009 to 2015.
Results showed low-volume facilities had higher rates of readmission, pneumonia, wound complications and mortality compared with high-volume facilities. However, low-volume facilities had lower rates of acute renal failure, deep vein thrombosis and acute respiratory failure, according to researchers. Researchers also found patients had lower rates of readmission and deep vein thrombosis, but higher rates of acute renal failure when treated by low-volume surgeons vs. high-volume surgeons.
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