Revista espanola de cirugia ortopedica y traumatologia · 2025
[Translated article] Predictive factors of hospital and nursing facility admission in the fixation of low-energy ankle fractures.
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Andrés-Peiró J V, Reverté-Vinaixa M M, Pujol-Alarcón O, Altayó-Carulla M, Castellanos-Alonso S, Teixidor-Serra J, Tomàs-Hernández J, Selga-Marsà J, Piedra-Calle C A, Blasco-Casado F, García-Sánchez Y, Joshi-Jubert N, Minguell-Monyart J
Аннотация
INTRODUCTION: Ankle fractures are increasingly common in frail patients, with hospitalisation being the principal cost driver, particularly for the elderly who often need referral to nursing facilities. This study aims to identify factors affecting resource utilisation per admission (hospital and nursing) in the fixation of low-energy ankle fractures.
MATERIALS AND METHODS: This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures. The primary outcome was the length of hospitalisation. Secondary outcomes included delays in fixation and the need for referral to a nursing institution. Multiple linear and logistic regression models were used to determine predictors related to patient demographics, injury characteristics, and treatment.
RESULTS: We analysed 651 patients with a median age of 58years. The median hospitalisation duration was 9days, primarily before surgery. Extended hospitalisation was associated with antithrombotic treatment (b=4.08), fracture-dislocation (2.26), skin compromise (7.56), complications (9.90), and discharge to a nursing centre (5.56). Referral to a nursing facility occurred in 17.2%, associated with older age (OR=1.10) and an ASA score≥III (6.96).
CONCLUSIONS: Prolonged hospitalisation was mainly due to surgical delays and was related to fracture-dislocations, skin compromise, and complications. Older and comorbid patients were more likely to need nursing facilities, and delays in these facilities' availability contributed to extended hospital stays.
MATERIALS AND METHODS: This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures. The primary outcome was the length of hospitalisation. Secondary outcomes included delays in fixation and the need for referral to a nursing institution. Multiple linear and logistic regression models were used to determine predictors related to patient demographics, injury characteristics, and treatment.
RESULTS: We analysed 651 patients with a median age of 58years. The median hospitalisation duration was 9days, primarily before surgery. Extended hospitalisation was associated with antithrombotic treatment (b=4.08), fracture-dislocation (2.26), skin compromise (7.56), complications (9.90), and discharge to a nursing centre (5.56). Referral to a nursing facility occurred in 17.2%, associated with older age (OR=1.10) and an ASA score≥III (6.96).
CONCLUSIONS: Prolonged hospitalisation was mainly due to surgical delays and was related to fracture-dislocations, skin compromise, and complications. Older and comorbid patients were more likely to need nursing facilities, and delays in these facilities' availability contributed to extended hospital stays.