Khoo Teck Puat Hospital1
Hip fracture incidence in the elderly is increasing worldwide. Shorter length of acute hospital stay post hip fracture surgery has been recognised to reduce medical and financial burden. This study aims to explore the factors associated with prolonged length of stay post hip fracture surgery.
In this retrospective cohort study, all subjects above 65 years old admitted to the hip fracture service in a tertiary hospital from 1st December 2016 to 31st April 2021 were included. Prolonged length of acute hospital stay was defined as more than 10 days. Association between length of stay and patient’s basic demographics and clinical data were studied using univariate and multivariate analysis.
A total of 1503 patients with a mean age of 79.26 were included. A univariate analysis revealed that patients who were frailer (higher CFS, higher Charlson Comorbidity Index, higher ASA and lower effort tolerance; p < 0.05) had a prolonged hospital stay. They were also more likely to have delayed surgery and post-operative complications. Pre-operative physical function (MBI score), type of anaesthesia and fracture type had no association with increased length of stay.
Increasingly frailer patients with more comorbidities tended to have prolonged hospital stay. Identifying risk factors for prolonged hospital stay post surgery allows better resource allocation according to patients’ complexity. While identified risk factors are largely non-modifiable, early surgery will help to reduce the risk of post-operative complications.