Predictors determining the duration of the hospital stay among patients admitted with single fractures
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Introduction: Fractures pose a tremendous burden on the health care systems due to the prolonged duration of admission. Addressing various determinants that prolong hospital stay will help minimize the cost of treatment.
Objective: To study the determinants associated with the duration of hospital stay among patients admitted with fractures.
Methods: This was a retrospective observational study conducted at a private tertiary care hospital in Mangalore. A semi-structured proforma was used for collecting data from the medical records.
Results: The mean age of the 124 patients were 48.3±21.4 years. The majority were males [69(55.6%)] and were from urban areas [86(69.4%)]. Co-morbidities were present among 69(55.6%) patients. Out of the total patients, 8(6.4%) were alcoholics, and 10(8.1%) were tobacco smokers. The majority [50(40.3%)] had fracture of the femur. Five(4%) patients developed complications during the post-operative period. Seventy-eight (62.9%) patients had medical insurance facilities.
The mean duration of hospital stay was 9.6±3.2 days among the patients. The mean duration of hospital stay among patients (n=115) before surgery was 2.4±1.6 days.
Increased pre-operative stay, increasing age, rural residential status, open type of fracture, and being given general anesthesia for the operative procedure were significant predictors determining the period of stay among patients in the hospitals. Alcoholic status independently influenced the period of stay in the pre-operative period.
Conclusion: Both patient and treatment characteristics were important determinants associated with the duration of hospital stay. Targeting these predictors will help to manage in-patients better and shorten their duration of hospital stay.
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Basques BA, Bohl DD, Golinvaux NS, Leslie MP, Baumgaertner MR, Grauer JN. Postoperative length of stay and 30-day readmission after geriatric hip fracture: an analysis of 8434 patients. J Orthop Trauma. March 2015 [cited 2020 Jan 8];29(3):e115-20. DOI: 10.1097/BOT.0000000000000222
Page K, Barnett AG, Graves N. What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers. BMC Health Serv Res. February 2017 [cited 2020 Jan 4];17(1):137. DOI: 10.1186/s12913-017-2079-5
Akshaya D, Sarala KS, Sharmila R. A study of select determinants for hospital stay among surgical patients in a tertiary care hospital. IJMAS. October 2016 [cited 2020 Jan 8];2(10):37-43.
Emergency Physicians Monthly. On Your Mark, Get Set, Triage! [Internet]; 2020 [cited 2020 Jan 7]. Available at: https://epmonthly.com/article/on-your-mark-get-set-triage/
Committee on Economics. ASA physical status classification system [Internet]; 2020 [cited 2020 Jan 7]. Available at: https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system
Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. August 2017 [cited 2020 Jan 13];12:2465-75. DOI: 10.2147/COPD.S141295
Richards T, Glendenning A, Benson D, Alexander S, Thati S. The independent patient factors that affect length of stay following hip fractures. Ann R Coll Surg Engl. September 2018 [cited 2020 Jan 13];100(7):556-62. DOI: 10.1308/rcsann.2018.0068
Ireland AW, Kelly PJ, Cumming RG. Total hospital stay for hip fracture: measuring the variations due to pre-fracture residence, rehabilitation, complications and comorbidities. BMC Health Serv Res. January 2015 [cited 2020 Jan 2];15:17. DOI: 10.1186/s12913-015-0697-3
Pereira HO, Rezende EM, Couto BR. Length of preoperative hospital stay: a risk factor for reducing surgical infection in femoral fracture cases. Rev Bras Ortop. October 2015 [cited 2020 Jan 5];50(6):638-46. DOI: 10.1016/j.rboe.2015.09.006
Grimes JP, Gregory PM, Noveck H, Butler MS, Carson JL. The effects of time-to-surgery on mortality and morbidity in patients following hip fracture. Am J Med. June 2002 [cited 2020 Jan 5];112(9):702-9. DOI: 10.1016/s0002-9343(02)01119-1
Husted H, Holm G, Jacobsen S. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop. April 2008 [cited 2020 Jan 8];79(2):168-73. DOI: 10.1080/17453670710014941
Kastanis G, Topalidou A, Alpantaki K, Rosiadis M, Balalis K. Is the ASA Score in Geriatric Hip Fractures a Predictive Factor for Complications and Readmission? Scientifica (Cairo). 2016 [cited 2020 Jan 3];2016:7096245. DOI: 10.1155/2016/7096245
Lakomkin N, Kothari P, Dodd AC, VanHouten JP, Yarlagadda M, Collinge CA, et al. Higher Charlson Comorbidity Index Scores Are Associated With Increased Hospital Length of Stay After Lower Extremity Orthopaedic Trauma. J Orthop Trauma. January 2017 [cited 2020 Jan 8];31(1):21-6. DOI: 10.1097/BOT.0000000000000701
Chona D, Lakomkin N, Bulka C, Mousavi I, Kothari P, Dodd AC, et al. Predicting the post-operative length of stay for the orthopaedic trauma patient. Int Orthop. May 2017 [cited 2020 Jan 8];41(5):859-68. DOI: 10.1007/s00264-017-3425-2
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