Factors Influencing Surgery After Two Days of Hospitalization and Outcomes in Hip Fractures: using a National Administrative Database

Abstract

Abstract The increasing number of surgeries following hip fractures is increasing medical costs globally. Prompt surgical interventions in hip fractures is to achieve the most favorable outcomes and minimizes the risk of complications. A retrospective review and analyzes using the Korean National Hospital Discharge In-depth Injury Survey database was used to identify the distribution within 2 days of hospitalization, the factors of after 2 days’ surgery in hip fractures, defined as patients having an injury code with a diagnosis of hip fracture and a hip fracture-related operation during 2015–2019. The proportion of patients in the two groups were compared using the chi-square test. In the analysis of factors associated with late surgery, multiple logistic regression analysis was performed. The mean hospital stay for hip fracture patients before surgery was 3.58 days with 40.6% of patients having surgery within 2 days of hospitalization. When multiple logistic regression was performed, male (OR 1.190), Medicaid beneficiary (OR 1.385), higher comorbidity (OR 1.365, OR1.612), weekends admission (2.384), Outpatient Hospitalization status (1.298), ORIF (0.823) were reasons for the late surgery. As the operation was delayed, the total length of stay (OR 1.028) and the length of stay after stay (OR 1.005) were extended. Late surgery did not affect death and complications in the hospital. However, the entire hospital stay of the patient and postoperative hospital stay were extended. Therefore, providers should establish a system for surgery as soon as possible after hospitalization of hip fracture patients and support measures.