Background
Methods
Design
Data sources and searches
Database | Search syntax |
---|---|
PubMed | (fracture[MeSH Terms]) AND (((readmi* or rehosp* or re-admi* or re-hosp* or re-presentation)) OR “Patient Readmission”[MeSH]) Filters: Aged: 65+ years |
CINAHL | “fracture* AND (readmi* or rehosp* or re-admi* or re-hosp* or re-presentation) Age Groups: Aged: 65+ year |
Embase | “fracture”/exp and (readmi* or rehosp* or re-admission or re-hospitalisation or re-hospitalization or re-presentation) AND ([aged]/lim OR [very elderly]/lim) |
Scopus | ABS fracture* AND (readmi* OR rehosp* OR re-admission OR re-hospitalisation OR re-hospitalization or re-presentation) AND (aged OR elderly OR geriatric OR old*) |
Study selection
Data extraction and quality assessment
Data synthesis and analysis
Results
Study characteristics
Author and year of publication | Country | Site | Study design | Sample characteristics | Sample size/population | Study time period | Fracture site |
---|---|---|---|---|---|---|---|
Basques et al. (2015) [30] | USA | 370 hospitals | Retrospective cohort | >70 years | 8434 | 2011–2012 | Hip |
Bischoff-Ferrari et al. (2010) [20] | Switzerland | Single hospital | Randomized controlled trial | ≥65 years | 173 | 2005–2007 | Hip |
Boddaert et al. (2014) [21] | France | Single hospital | Interrupted time series | ≥70 years | 334 | 2005–2012 | Hip |
Fox et al. (1998) [31] | USA | 8 hospitals | Prospective cohort | ≥65 years | 306 | 1990–1991 | Hip |
French et al. (2008) [25] | USA | Veterans Health Administration Medical Centre | Retrospective cohort | ≥65 years | 41,331 | 1999–2003 | Hip |
Giusti et al. (2008) [32] | Italy | Single hospital | Prospective cohort | ≥70 years | 236 | 2000–2001 | Hip |
Golinvaux et al. (2014) [48] | USA | 350 hospitals | Retrospective cohort | ≥65 years | 9938 | 2005–2012 | Hip |
Gregersen et al. (2011) [42] | Denmark | Single hospital | Prospective cohort | ≥65 years (Nursing Home Residents) | 233 | 2006–2010. | Hip |
Hageman et al. (2014) [43] | USA | Level 1 trauma center | Retrospective cohort | Mean age > 65 | 890 | 2008–2011 | Hip |
Halm et al. (2003) [27] | USA | 4 hospitals | Prospective cohort | Mean age > 65 | 559 | 1997–1998 | Hip |
Halm et al. (2003) [33] | USA | 4 hospitals | Prospective cohort | Mean age > 65 | 551 | 1997–1998 | Hip |
Halm et al. (2004) [34] | USA | 4 hospitals | Prospective cohort | Mean age > 65 | 550 | 1997–1998 | Hip |
Härstedt et al. (2015) [35] | Sweden | Single hospital | Prospective cohort | Mean age > 65 | 272 | 2009–2011 | Hip |
Heidari et al. (2012) [26] | UK | 62 hospital pharmacies | Retrospective cohort | Mean age > 65 | 255,841 | 2003–2007 | Hip |
Heyes et al. (2015) [29] | Ireland | Single hospital | Prospective cohort | Mean age > 65 | 451 | 2010–2012 | Hip |
Hsaio et al. (2011) [23] | Taiwan | Health insurance database | Retrospective cohort | Mean age > 65 (women) | 11,278 | 2001–2007 | Hip/Vertebra |
Intrator and. Berg (1998) [44] | USA | Medicare beneficiaries | Retrospective cohort | ≥70 years | 324 | 1987–1991 | Hip |
Jou et al. (2014) [24] | Taiwan | Health insurance database | Retrospective cohort | Mean age > 65 (women) | 9467 | 2003–2006 | Hip |
Kates et al. (2014) [28] | USA | Level 3 trauma center | Retrospective cohort | ≥65 years | 1081 | 2005–2010 | Hip |
Kates et al. (2015) [49] | USA | Level 3 trauma center | Retrospective cohort | ≥65 years | 1081 | 2005–2010 | Hip |
Khan et al. (2012) [36] | UK | Single hospital | Retrospective cohort | Mean age > 65 | 467 | 2009–2010 | Hip |
Kiel et al. (1994) [45] | USA | 43 nursing homes | Prospective cohort | Mean age > 65 | 2624 | 1984–1988 | Hip |
Le-Wendling et al. (2012) [37] | USA | Single hospital | Retrospective cohort | ≥65 years | 308 | 2006–2008 | Hip |
Ling et al. (2013) [19] | Singapore | Single hospital | Retrospective cohort | Mean age > 65 | 254 | 2009–2010 | Hip |
Merchant et al. (2005) [38] | Singapore | Single hospital | Retrospective cohort | Mean age > 65 | 180 | 2001–2001 | Hip |
Ottenbacher et al. (2003) [46] | USA | 171 hospitals | Retrospective cohort | Mean age > 65 | 9956 | 1994–1998 | Hip |
Pollock et al. (2015) [50] | USA | Level 1 trauma center | Retrospective cohort | Mean age > 65 | 1482 | 2005–2012 | Hip |
Radcliff et al. (2008) [51] | USA | Veterans Health Administration Medical Center | Retrospective cohort | Mean age > 65 | 5683 | 1998–2003 | Hip |
Riggs et al. (2010) [39] | USA | Single hospital | Retrospective cohort | ≥65 years | 606 | 2004–2006 | Hip |
Teixeira et al. (2009) [40] | France | Single hospital | Retrospective cohort | ≥70 years | 5709 | 2005–2006 | Hip |
Toson et al. (2015) [53] | Australia | 247 hospitals | Retrospective cohort | Mean age > 65 | 47,698 | 2001–2010 | Hip |
Toy et al.(2014) [41] | USA | 370 hospitals | Retrospective cohort | ≥65 years | 850 | 2011–2012 | Vertebra |
Tsai et al. (2013) [47] | Taiwan | National Health Insurance | Retrospective cohort | ≥70 years | 9238 | 2004–2007 | Vertebra |
Vochteloo et al. (2011) [22] | Netherlands | 450 hospitals | Retrospective and prospective cohort | ≥65 years | 1222 | 2005–2010 | Hip |
Zhang et al. (2014) [52] | USA | State Inpatient Database | Retrospective cohort | Mean age > 65 | 27,017 | 2005–2010 | Proximal humerus |
Risk factors associated with re-presentations
Study | Patient characteristics | Association | Clinical/service characteristics | Association | Percentage of re-presentations |
---|---|---|---|---|---|
Readmission
a
within 30 days
| |||||
Readmission within 7 days from discharge
| |||||
Tsai (2013) [47] | Hospitalization for all reasons | OR = 0.48 (0.32–0.72) | Not investigated | Hospitalization for all reasons: 3.44 % | |
Fracture related diagnoses | OR = 0.28 (0.12–0.68) | Fracture related diagnoses: 0.69 % | |||
Musculoskeletal disorder | OR = 0.08 (0.01–0.88) | Musculoskeletal disorders: 0.20 % | |||
Hospitalization for other diagnoses | OR = 0.67 (0.41–1.09) | Hospitalization for other diagnoses: 2.55 % | |||
Readmission within 14 days from discharge
| |||||
Jou et al. (2014) [24] | 14 days: | 14 days: Medical center | Referent | 50–74 y (3.21 %) | |
Age < 75 Age ≥ 75 | Referent | Regional hospital District hospital |
HR = 1.56 (1.08–2.25)
| ||
HR = 1.36 (1.08–1.71)
|
HR = 4.47 (3.20–6.26)
| ||||
14 days: CCI score 0 CCI score ≥ 2 | LOS ≤10 days ≥11 days | ≥75 y (4.16 %) | |||
Referent | Referent | ||||
HR = 1.52 (1.22–1.92)
| HR = 0.25 (0.19–0.34) | ||||
14 days: Geographic regions | |||||
Northern Central Southern Eastern | Referent | ||||
HR = 1.21 (0.89–1.64) | |||||
HR = 1.17 (0.89–1.54) | |||||
HR = 0.96 (0.47–1.96) | |||||
Readmission within 28 days from discharge
| |||||
Khan et al. (2012) [36] | Age |
OR = 1.06 (1.02–1.10)
| Not investigated | 11 % | |
Diabetes |
OR = 3.34 (1.54–7.25)
| ||||
History of neurological disorders |
OR = 5.66 (2.79–11.47)
| ||||
Admission other than home |
OR = 2.36 (1.19–4.66)
| ||||
Readmission within 30 days from discharge
| |||||
Boddaert et al. (2014) [21] | CIRS score |
RR = 1.08 (1.00–1.16)
| Intervention vs. control group |
RR = 0.40 (0.23–0.70)
| Orthopedic group (usual care) = 17 % |
Age | RR = 0.99 (0.95–1.03) | Geriatric group (intervention) = 5 % | |||
Male sex | RR = 0.76 (0.41–1.41) | ||||
French et al. (2008) [25] | Chronic heart failure |
OR = 1.24 (1.16–1.33)
| Inpatient LOS |
OR = 1.01 (1.01–1.02)
| 18 % |
Cardiac arrhythmias |
OR = 1.11 (1.04–1.17)
| 30 % occurred in the first week | |||
Other neurological disorder |
OR = 1.15 (1.05–1.26)
| 60 % within 2 weeks | |||
Chronic pulmonary disease |
OR = 1.33 (1.25–1.40)
| 81 % within 3 weeks | |||
Diabetes mellitus without chronic complication | |||||
OR = 1.32 (1.15–1.52)
| |||||
Renal failure |
OR = 1.43 (1.29–1.60)
| ||||
Coagulopathy |
OR = 1.33 (1.16–1.52)
| ||||
Weight loss |
OR = 1.24 (1.07–1.44)
| ||||
Fluid and electrolyte disorders |
OR = 1.11 (1.04–1.20)
| ||||
Deficiency anemia |
OR = 1.16 (1.09–1.25)
| ||||
Alcohol abuse | OR = 0.86 (0.75–0.98) | ||||
Psychosis | OR = 1.16 (1.00–1.34) | ||||
Depression | OR = 1.06 (0.95–1.18) | ||||
Heidari et al. (2012) [26] | Not investigated | Hospital drug policy for chemical thromboprophylaxis | 55 % | ||
Aspirin | OR = 1.03 (0.87–1.23) | ||||
Heparin drug policy | OR = 1.06 (0.97–1.16) | ||||
Low-dose heparin | OR = 1.09 (0.93–1.28) | ||||
Jou et al. (2014) [24] | 30 days: | 30 days: Medical center | Referent | 50–74 y (3.21 %) ≥75 y (4.87 %) | |
Age < 75 Age ≥ 75 | Referent | Regional hospital District hospital |
HR = 1.51 (1.10-2.09)
| ||
HR = 1.34 (1.07–1.62)
|
HR = 3.82 (2.83–5.14)
| ||||
30 days: | LOS | ||||
CCI score 0 CCI score ≥ 2 | Referent | ≤10 days ≥11 days | Referent | ||
HR = 1.60 (1.30–1.97)
| HR = 0.32 (0.25–0.41) | ||||
30 days: Geographical regions | |||||
Northern Central Southern Eastern | Referent | ||||
HR = 1.25 (0.94–1.67) | |||||
HR = 1.20 (0.93–1.54) | |||||
HR = 1.00 (0.52–1.92) | |||||
Kates et al. (2014) [28] | Age > 85 |
OR = 1.52 (1.02–2.26)
| Time to surgery > 24 h | OR = 1.50 (1.00–2.25) | 11 % |
CCI ≥ 4 |
OR = 1.70 (1.02–2.81)
| ||||
Delirium |
OR = 1.65 (1.13–2.40)
| ||||
Dementia |
OR = 1.61 (1.12–2.33)
| ||||
History of arrhythmia with pacemaker |
OR = 1.75 (1.11–2.76)
| ||||
Placement presence of a pre-op arrhythmia |
OR = 1.62 (1.09–2.39)
| ||||
Partial or complete disability with ADL |
OR = 1.54 (1.05–2.26)
| ||||
Kates et al. (2015) [49] | Age > 85 |
OR = 1.58 (1.02–2.26)
| Not investigated | 11.9 % | |
Male | OR = 1.49 (1.00–2.24) | ||||
Assisted living | OR = 1.52 (0.82–2.59) | ||||
Skilled nursing | OR = 1.24 (0.84–1.85) | ||||
Parker mobility medium (5–8) | OR = 1.81 (0.98–3.35) | ||||
Parker mobility low (0–4) | OR = 1.50 (0.85–2.64) | ||||
Charlson score medium (2–3) | OR = 1.51 (1.03–2.25) | ||||
Charlson score high (4 or more) | OR = 1.65 (1.00–2.74) | ||||
Partial or complete disability |
OR = 1.51 (1.03–2.25)
| ||||
Delirium |
OR = 1.66 (1.14–2.41)
| ||||
Preoperative arrhythmia |
OR = 1.62 (1.09–2.39)
| ||||
Hematoma | OR = 7.51 (0.47–1.21) | ||||
Urinary tract infection | OR = 1.84 (0.39–8.84) | ||||
Pacemaker |
OR = 1.75 (1.11–2.76)
| ||||
Diabetes |
OR = 1.91 (1.22–2.99)
| ||||
Dementia |
OR = 1.61 (1.12–2.22)
| ||||
GERD | OR = 1.44 (0.99–2.10) | ||||
Cardiac disease | OR = 1.02 (0.66–1.59) | ||||
Alcoholism | OR = 1.12 (0.46–2.68) | ||||
Tobacco use | OR = 0.99 (0.56–1.73) | ||||
Le-Wendling et al. (2012) [37] | Not investigated | Local vs. general anesthetic | OR = 2.0 (1.0-4.0) | 19 % | |
Pollock et al. (2015) [50] | Pre-existing pulmonary disease |
OR = 1.88 (1.30–2.72)
| Discharge to skilled nursing facility |
OR = 1.5 (1.04–2.14)
| 9 % |
Hospital LOS > 8 days |
OR = 1.88 (1.30–2.72)
| ||||
Toson et al. (2015) [53] | Myocardial infarction | OR = 1.1 (1.0–1.2) | Not investigated | 16 % | |
Congestive heart failure |
OR = 1.2 (1.1–1.3)
| ||||
Peripheral vascular disease | OR = 1.2 (1.0–1.3) | ||||
Cerebrovascular accident | OR = 1.1 (1.0–1.2) | ||||
Dementia | OR = 0.8 (0.8–0.9) | ||||
Chronic pulmonary disease | OR = 1.1 (1.0–1.2) | ||||
Connective tissue disorder | OR = 1.2 (1.0–1.4) | ||||
Peptic ulcer | OR = 1.2 (1.0–1.5) | ||||
Mild liver disease | OR = 1.3 (1.0–1.7) | ||||
Diabetes without chronic complications | |||||
OR = 1.1 (1.0–1.2) | |||||
Diabetes with chronic complications |
OR = 1.2 (1.1–1.3)
| ||||
Hemiplegic or paraplegia | OR = 0.9 (0.8–1.1) | ||||
Renal disease |
OR = 1.3 (1.2–1.5)
| ||||
Any malignancy |
OR = 1.4 (1.2–1.6)
| ||||
Metastatic solid tumor | OR = 1.1 (0.9–1.4) | ||||
Moderate or severe liver disease | OR = 5.0 (3.3–7.5) | ||||
Readmission within 30 days post-operative
| |||||
Basques et al. (2015) [30] | Age ≥ 90 |
OR = 1.35 (1.09–1.67)
| Discharge to a facility |
OR = 1.42 (1.08–1.86)
| 10 % |
Male |
OR = 1.40 (1.20–1.63)
| ASA class 3 |
OR = 1.40 (1.09–1.69)
| ||
BMI ≥ 35 |
OR = 1.73 (1.24–2.44)
| ASA class 4 |
OR = 1.90 (1.44–2.51)
| ||
History of pulmonary disease |
OR = 1.46 (1.22–1.75)
| ||||
Hypertension |
OR = 1.21 (1.02–1.45)
| ||||
Steroid use |
OR = 1.38 (1.04–1.83)
| ||||
Partially dependent functional status |
OR = 1.31 (1.11–1.54)
| ||||
Fully dependent functional status |
OR = 1.41 (1.01–1.97)
| ||||
Golinvaux (2014) [48] | Non-insulin dependent diabetes mellitus | Not investigated | Without diabetes = 5 %, Non-insulin dependent diabetes mellitus = 7 %, | ||
RR = 1.4 (1.0–2.0) | Insulin dependent diabetes mellitus = 7 % | ||||
Insulin-dependent diabetes mellitus | RR = 1.4 (0.9–2.2) | ||||
Hageman et al. (2014) [43] | CCI and age | OR = 1.1, P < 0.01, R2 = 0.03 | Not investigated | 2 % readmitted without surgical adverse event | |
4 % readmitted with surgical adverse event | |||||
Ling et al. (2013) [19] | Age 60–70 | Referent | Not investigated | 9 % | |
Age 70–80 | OR = 1.60 (0.31–8.22) | ||||
Age 80–90 | OR = 3.91 (0.83–18.4) | ||||
Age > 90 |
OR = 7.21 (1.28–40.65)
| ||||
Female | Referent | ||||
Male | OR = 0.75 (0.27–2.10) | ||||
Intertrochanteric | OR = 0.84 (0.36–1.95) | ||||
Comorbidity = 0 | Referent | ||||
Comorbidity > 1 | OR = 0.73 (0.26–2.04) | ||||
Comorbidity > 2 | OR = 0.48 (0.10–2.26) | ||||
Comorbidity > 3 | OR = 1.53 (0.45–5.19) | ||||
Renal failure | OR = 2.49 (0.50–12.4) | ||||
Serum albumin | OR = 2.09 (0.69–6.36) | ||||
Serum iPTH | OR = 1.01 (0.42–2.47) | ||||
Vitamin D deficiency | OR = 1.00 (0.43–2.33) | ||||
Euthyroid | Referent | ||||
Overt hypothyroidism | OR = 1.75 (0.35–8.89) | ||||
Thyroid dysfunction | OR = 1.19 (0.47–3.03) | ||||
Subclinical hypothyroidism | OR = 0.44 (0.05–3.54) | ||||
Radcliff (2008) [51] | White race | OR = 1.32 | Plate/screw (CPT 27244) | OR = 1.26 | 7 % |
Age 65–74 | Referent | Open reduction (CPT 27236) | OR = 1.13 | ||
Age 75–84 | OR = 1.17 | Hemiarthroplasty (CPT 27125) | OR = 1.30 | ||
Age ≥ 85 | OR = 0.95 | Percutaneous fixation (CPT 27235) | OR = 1.05 | ||
Currently smoking | OR = 0.94 | Intramedullary implant (CPT 27245) | OR = 0.92 | ||
Alcohol use (>2 drinks/day) | OR = 1.29 | General anesthesia | OR = 0.97 | ||
Partial independence | OR = 1.04 | Blood transfusion (1 U) | OR = 1.01 | ||
Total independence | OR = 0.70 | Surgery 4 days after admission | OR = 0.70 | ||
Impaired sensorium |
OR = 1.67
| Weekend surgery | OR = 1.15 | ||
Renal insufficiency |
OR = 1.46
| Wound not “clean” | OR = 1.44 | ||
Steroid use | OR = 1.10 | Emergency admission | OR = 0.74 | ||
Disseminated cancer | OR = 0.87 | ASA class 3 | OR = 1.38 | ||
Congestive heart failure | OR = 1.28 | ASA class 4 or 5 | OR = 1.60 | ||
Dementia | OR = 0.75 | ||||
Diabetes | OR = 1.09 | ||||
Hemiplegia | OR = 1.02 | ||||
Severe chronic obstructive pulmonary disease | OR = 1.24 | ||||
Recent weight loss | OR = 0.99 | ||||
Hyponatremia | OR = 1.73 | ||||
Toy et al. (2014) [41] | History of pulmonary disease | OR = 2.0 | Inpatient status before procedure | OR = 1.9 | 10.8 % |
Tsai (2013) [47] | Hospitalization for all reasons | OR = 0.74 (0.59–0.93) | Not investigated | Hospitalization for all reasons: 14.73 % | |
Fracture related diagnoses | OR = 0.69 (0.45–1.05) | Fracture-related diagnoses: 3.73 % | |||
Musculoskeletal disorders | OR = 0.60 (0.37–0.98) | Musculoskeletal disorders: 2.36 % | |||
Hospitalization for other diagnoses | OR = 0.83 (0.62–1.12) | Hospitalization for other diagnoses: 9.23 % | |||
Readmission to hospital within 30 days of admission to nursing home
| |||||
Kiel et al. (1994) [45] | Age 74–85 | OR = 0.58 (0.40–0.83) | Not investigated | 12.4 % | |
Age > 85 | OR = 0.55 (0.38–0.80) | ||||
Secondary neurological diagnoses | OR = 0.75 (0.56–1.00) | ||||
Living with someone |
OR = 1.44 (1.12–1.87)
| ||||
Any dependency in ADLs |
OR = 1.45 (1.08–1.93)
| ||||
Ability to walk |
OR = 1.54 (1.16–2.05)
| ||||
Readmission >30 days
| |||||
Readmission to hospital within 60 days from discharge
| |||||
Halm et al. (2003) [27] | Active clinical issue in the 24 h before discharge | OR = 1.6 (1.0–2.6) | Not investigated | 18.8 % | |
New impairment in the 24 h before discharge |
OR = 1.7 (1.2–2.3)
| ||||
Halm et al. (2003) [33] | Transfusion when Hb < 10.0 g/dL | OR = 0.52 (0.28–0.97) | 16.9 % | ||
Halm et al. (2004) [34] | Hb on admission | OR = 0.69 (0.49–0.95) | Not investigated | 16.9 % | |
Hb lowest preoperative | OR = 0.65 (0.48–0.89) | ||||
Hb lowest postoperative | OR = 0.78 (0.64–0.95) | ||||
Readmission within 80 and 180 days
| |||||
Ottenbacher et al. (2003) [46] | Age | Beta = 0.943, SEM = 0.374, LR = 3.51 | Not investigated | 16.7 % | |
Ethnicity × gender | Beta = 0.012, SEM = 0.005, LR = 2.54 | ||||
FIM rating | Beta = −0.825, SEM = 0.293, LR = 4.86 | ||||
Readmission within 90 days from discharge
| |||||
Vochteloo et al. (2011) [22] | Age | OR = 0.97 (0.94-0.99) | ASA | OR = 1.43 (0.99–2.09) | Anemic group 12.9 %, Non-anemic group 9.0 % |
Anemia |
RR = 1.24 (1.04–1.49)
| General anesthesia | OR = 0.35 (0.13–0.99) | ||
Readmission 90 days from surgery
| |||||
Zhang et al. (2014) [52] | Male | HR = 0.77 (0.72–0.83) | Hemiarthroplasty | HR = 0.77 (0.71–0.83) | 90 day readmission rate = 14 % |
African-American race |
HR = 1.22 (1.02–1.46)
| RTSA | HR = 0.82 (0.67–0.99) | 15 % for open reduction-internal fixation and RTSA | |
Medical comorbidities (per diagnosis) |
HR = 1.20 (1.18–1.22)
| 13 % for hemiarthroplasty | |||
Insurance with Medicaid |
HR = 1.27 (1.08–1.49)
| ||||
Private insurance | HR = 0.82 (0.74–0.91) | ||||
Discharge status – home with services |
HR = 1.19 (1.07–1.32)
| ||||
Transfer to facility nursing or rehab | HR = 1.99 (0.82–2.18) | ||||
Gregersen et al. (2011) [42] | Postop Hb levels ≤ 6 mmol/L |
OR = 3.24 (1.15–9.14)
| Intervention care | OR = 0.47 (0.23–0.94) | 14 % intervention care |
Age |
OR = 2.98 (1.08–8.21)
| 26 % standard care | |||
Readmission within 180 days from surgery
| |||||
Tsai (2013) [47] | Hospitalization for all reasons | OR = 0.93 (0.78–1.38) | Not investigated | Hospitalization for all reasons: 38.31 % | |
Fracture related diagnoses | OR = 0.90 (0.67–1.21) | Fracture related diagnoses: 9.14 % | |||
Musculoskeletal disorders | OR = 1.03 (0.77–1.38) | Musculoskeletal disorders: 9.43 % | |||
Hospitalization for other diagnoses | OR = 0.93 (0.77–1.13) | Hospitalization for other diagnoses: 26.72 % | |||
Readmissions within 6 months from discharge
| |||||
Härstedt et al. (2015) [35] | Hypertension |
OR = 2.0 (1.2–1.9)
| Not investigated | 32 % | |
Atrial Fibrillation | OR = 0.80 (0.40–1.61) | 73 % were admitted once only | |||
Myocardial infarction | OR = 0.70 (0.30–1.64) | ||||
Angina pectoris | OR = 0.49 (0.19–1.26) | ||||
Heart failure | OR = 0.69 (0.29–1.61) | ||||
Pacemaker |
OR = 6.64 (1.68–26.33)
| ||||
Valvular heart disease | OR = 0.87 (0.17–4.60) | ||||
Syncope | OR = 0.99 (0.36–2.71) | ||||
Stroke | OR = 0.66 (0.31–1.40) | ||||
Pulmonary embolism/deep vein thrombosis | OR = 2.72 (0.80–9.24) | ||||
Peripheral vascular disease | OR = 1.01 (0.33–3.08) | ||||
Parkinson’s disease | OR = 1.32 (0.32–5.70) | ||||
Epilepsy | OR = 0.26 (0.03–2.15) | ||||
Cognitive disorder (dementia) | OR = 1.68 (0.94–3.01) | ||||
Depression | OR = 1.54 (0.63–3.78) | ||||
Diabetes mellitus | OR = 0.64 (0.29–1.42) | ||||
Thyroid disease | OR = 1.47 (0.70–3.12) | ||||
Respiratory disease (COPD) | OR = 0.98 (0.42–2.26) | ||||
Malignancy | OR = 1.16 (0.57–2.37) | ||||
Autoimmune disorders | OR = 2.30 (0.87–6.10) | ||||
Prostate tumor (men) | OR = 4.99 (0.92–27.18) | ||||
Previous fracture | OR = 1.70 (0.86–3.36) | ||||
Osteoporosis | OR = 0.30 (0.07–1.40) | ||||
Diseases in the kidney and urinary tract | |||||
OR = 1.72 (0.57–5.16) | |||||
Anemia | OR = 1.19 (0.43–3.32) | ||||
ASA classification per one grade | OR = 1.67 (0.99–2.80) | ||||
Riggs et al. (2010) [39] | Discharge to rehabilitation | Standard coeff −0.095 (−0.102 to −0.11) | LOS 75th quartile ≥ 9 days) | Standard coefficient 0.151 (0.044–0.141) | 8.3 % |
Any days in Intensive Care Unit | Standard coefficient 0.168 (0.097–0.271) | ||||
Readmission after 12 months from discharge
| |||||
Bischoff- Ferrari (2010) [20] | 2000- vs. 800-IU/d dosage of cholecalciferol | Relative rate different, −39 % (−62 % to −1 %) | 70 % had 1 readmission, 22 % had 2 readmissions and 7 % had 3 readmissions | ||
Efficacy analysis: 2000 IU/d dose | Relative rate different, −55 % (−79 % to −2 %) | ||||
Giusti et al. (2008) [32] | Age 76–85 | OR = 0.77 (0.29–2.01) | Not investigated | 30.1 % | |
Age > 85 | OR = 0.46 (0.16–1.29) | ||||
CIRS-SI 1.5–1.9 |
OR = 5.95 (1.66–21.3)
| ||||
CIRS-SI > 1.9 |
OR = 7.05 (1.68–29.7)
| ||||
2 month ADL Katz Index 0–2 |
OR = 3.02 (1.09–8.32)
| ||||
Heyes et al. (2015) [29] | Female | OR = 1.34 (0.65–2.76) | Time to surgery 36 h to 6 days | OR = 1.62 (0.156–2.44) | 44 % |
Cephalomedullary nail | OR = 1.51 (0.40–1.08) | >6 days | OR = 1.29 (0.198–3.02) | ||
Hip hemiarthroplasty/THR | OR = 3.10 (0.19–1.80) | Inpatient stay > 7 days |
OR = 3.13 (0.12 –0.62)
| ||
Moderate alcoholic | OR = 1.36 (0.31–1.73) | Inpatient stay of 7–14 days |
OR = 7.04 (0.05 –0.34)
| ||
Alcoholic | OR = 1.52 (0.26–1.66) | Inpatient stay of 14–21 days |
OR = 2.90 (0.18 –0.64)
| ||
Affected side-right | OR = 1.10 (0.57–1.45) | Inpatient stay of 21–28 days | OR = 1.83 (0.25–0.16) | ||
Ex-smoker | OR = 1.14 (0.64–2.00) | Inpatient stay of 28–35 days | OR = 2.11 (0.19–1.17) | ||
Smoker | OR = 1.24 (0.56–2.72) | ASA score > 2 | OR = 3.68 (0.06–1.15) | ||
Residential care/nursing home residence |
OR = 1.71 (1.34–1.98)
| ASA score > 3 | OR = 1.95 (0.17–1.48) | ||
ASA score > 4 | OR = 2.14 (0.16–1.33) | ||||
Hb > 2 g/dL drop | OR = 1.29 (0.48–1.24) | Transfusion status < 2 units | OR = 1.12 (0.31–4.00) | ||
Admission glucose > 7.8 mmol/L | OR = 1.18 (0.66–2.09) | Transfusion status > 2 units | OR = 1.85 (0.48–7.04) | ||
Discharge glucose > 7.8 mmol/L | OR = 1.05 (0.53–1.70) | ||||
Total protein | OR = 1.13 (0.53–1.46) | ||||
Admission eGFR < 45 | OR = 1.04 (0.50–1.83) | ||||
Discharge eGFR < 45 | OR = 1.04 (0.47–1.96) | ||||
Hsaio et al. (2011) [23] | Long-term use of alendronate reduces risk | HR = 0.27 (0.15–0.78) | Not investigated | 8.6 % cases untreated cohort; 6.3 % alendronate users; 7.6 % other anti organophosphorous drug users | |
Intrator et al. (1998) [44] | Home healthcare usage | OR = 0.77 (0.52–1.15) | Not investigated | Rehab only group 34.1 % Rehab and home health group 27.2 % | |
Jou et al. (2014) [24] | 1 year: | 1 year: District hospital |
HR = 2.24 (1.82–2.75)
| 50–74 y (6.02 %) | |
Age < 75 Age ≥ 75 | Referent | LOS | ≥75 y (8.38 %) | ||
HR = 1.46 (1.24–1.73)
| ≤10 days ≥11 days | Referent | |||
1 year: CCI = 0 CCI score ≥ 2 | Referent | HR = 0.51 (0.43–0.60) | |||
HR = 1.28 (1.09–1.51)
| 1 year: Geographic regions | ||||
Northern Central Southern Eastern | Referent | ||||
HR = 1.12 (0.90–1.39) | |||||
HR = 1.07 (0.88–1.29) | |||||
HR = 0.89 (0.54–1.46) | |||||
Merchant (2005) [38] | Post-operative complications | After adjustment for potential covariates the presence of postoperative complications was not significant (P > 0.05, coefficients not presented) | Not investigated | 31.7 % | |
Teixeira et al. (2009) [40] | Male (predicts related first readmission) |
HR = 1.25 (1.08–1.46)
| Teaching hospital vs. public hospital (predicts related first readmission) | 32 % | |
Male |
HR = 1.36 (1.16–1.59)
| HR = 0.86 (0.79–0.95) | |||
Increasing age (predicts unrelated first readmission) | HR = 0.94 (0.89–0.99) | Index stay in a private hospital | HR = 0.78 (0.67–0.9) | ||
Cancer |
HR = 1.41 (1.03–1.94)
| Teaching hospital (predicts unrelated first readmission) | HR = 0.87 (0.79–0.95) | ||
Kidney disease | HR = 1.38 (1.00–1.90) | ||||
Dementia (predicts related first readmission) |
HR = 1.21 (1.01–1.46)
| ||||
Dementia (predicts unrelated first readmission) | HR = 0.68 (0.53–0.87) | ||||
Readmission within 18 months from discharge
| |||||
Fox et al. (1998) [31] | Performance on balance tests at 2 months post fracture | Beta = −0.155, P = 0.01 | |||
Gait score | Beta = −0.013, P = 0.83 | ||||
Mobility score | Beta = −0.098, P = 0.11 |
Patient characteristics
Other clinical and hospital indicators
Quality assessment
Lead author | Year | Selection bias | Study design | Confounder | Blinding | Data collection | Dropouts & withdrawals | Global rating |
---|---|---|---|---|---|---|---|---|
Basques | 2015 [30] | Moderate | Moderate | Moderate | Moderate | Strong | Weak | Moderate |
Bischoff-Ferrari | 2010 [20] | Weak | Strong | Strong | Strong | Moderate | Strong | Strong |
Boddaert | 2014 [21] | Moderate | Moderate | Strong | Moderate | Strong | Strong | Strong |
Fox | 1998 [31] | Weak | Moderate | Weak | Moderate | Strong | Weak | Weak |
French | 2008 [25] | Moderate | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Giusti | 2008 [32] | Strong | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Golinvaux | 2014 [48] | Moderate | Moderate | Strong | Moderate | Strong | Strong | Strong |
Gregersen | 2011 [42] | Moderate | Moderate | Strong | Moderate | Strong | Strong | Strong |
Hageman | 2014 [43] | Moderate | Moderate | Weak | Moderate | Strong | Weak | Weak |
Halm | 2003 [27] | Strong | Moderate | Strong | Moderate | Strong | Strong | Strong |
Halm | 2003 [33] | Strong | Moderate | Strong | Moderate | Strong | Strong | Strong |
Halm | 2004 [34] | Strong | Moderate | Strong | Moderate | Strong | Strong | Strong |
Härstedt | 2015 [35] | Strong | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Heyes | 2015 [29] | Moderate | Moderate | Weak | Moderate | Strong | Moderate | Moderate |
Heidari | 2012 [26] | Moderate | Moderate | Strong | Moderate | Strong | Weak | Moderate |
Hsaio | 2011 [23] | Moderate | Moderate | Strong | Moderate | Weak | Weak | Weak |
Intrator | 1998 [44] | Weak | Moderate | Strong | Moderate | Strong | Strong | Weak |
Jou | 2014 [24] | Moderate | Moderate | Strong | Moderate | Weak | Weak | Weak |
Kates | 2014 [28] | Moderate | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Kates | 2015 [49] | Moderate | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Khan | 2012 [36] | Moderate | Moderate | Weak | Moderate | Strong | Moderate | Moderate |
Kiel | 1994 [45] | Moderate | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Le-Wendling | 2012 [37] | Moderate | Moderate | Strong | Moderate | Weak | Strong | Moderate |
Ling | 2013 [19] | Moderate | Moderate | Moderate | Moderate | Strong | Weak | Moderate |
Merchant | 2005 [38] | Moderate | Moderate | Moderate | Moderate | Strong | Strong | Strong |
Ottenbacher | 2003 [46] | Moderate | Moderate | Weak | Moderate | Strong | Moderate | Moderate |
Pollock | 2015 [50] | Moderate | Moderate | Weak | Moderate | Strong | Weak | Weak |
Radcliff | 2008 [51] | Moderate | Moderate | Strong | Moderate | Strong | Strong | Strong |
Riggs | 2010 [39] | Moderate | Moderate | Moderate | Moderate | Strong | Weak | Moderate |
Teixeira | 2009 [40] | Moderate | Moderate | Moderate | Moderate | Strong | Strong | Strong |
Toson | 2015 [53] | Moderate | Moderate | Moderate | Moderate | Strong | Moderate | Strong |
Toy | 2014 [41] | Moderate | Moderate | Weak | Moderate | Strong | Strong | Moderate |
Tsai | 2013 [47] | Moderate | Moderate | Strong | Moderate | Weak | Weak | Moderate |
Vochteloo | 2011 [22] | Moderate | Moderate | Strong | Moderate | Strong | Weak | Moderate |
Zhang | 2014 [52] | Moderate | Moderate | Weak | Moderate | Moderate | Weak | Weak |