Risk Factors for Readmission Within 30 Days After Discharge Following Hip Fracture Surgery: A Systematic Review and Meta-Analysis.

Background/

Objectives

Hip fractures in older patients frequently lead to early readmissions, which negatively impact patient outcomes and significantly increase healthcare costs. Identifying and understanding risk factors for 30-day readmission following hip fracture surgery is essential for improving patient management and optimizing healthcare resource utilization.

Methods

A systematic literature search was conducted using PubMed, EMBASE, and the Cochrane Library databases up to 30 December 2024. Studies investigating potential risk factors for 30-day readmission following hip fracture surgery were included. The risk factors were meta-analytically pooled, and odds ratios (ORs) were calculated using a random-effects model.

Results

Twelve studies comprising 128,053 patients were included. Pooled analyses revealed significant associations between higher readmission rates and factors such as male sex (OR = 1.45; 95% CI, 1.27-1.65), hip arthroplasty surgery (OR = 1.36; 95% CI, 1.03-1.80), advanced age (OR, 1.22; 95% CI 1.00-1.49), high American Society of Anesthesiologists (ASA) Physical Status Classification System class (OR, 2.22; 95% CI, 1.28-3.85), and high Charlson comorbidity index (OR, 1.67; 95% CI, 1.36-2.05). Additionally, the most frequently reported comorbidities associated with higher readmission risks were diabetes mellitus and congestive heart failure, with ORs of 1.63 and 1.57, respectively.

Conclusions

Male sex, advanced age, higher ASA scores, and greater preoperative comorbidity burdens significantly increase the risk of 30-day readmission following hip fracture surgery. Effective risk stratification and targeted perioperative management strategies addressing these identified factors may reduce early readmission rates and enhance postoperative patient outcomes.