Abstract
BackgroundThe aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain.MethodsWe analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost.ResultsA total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49).ConclusionsIn-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.
Highlights
The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain
We identified every patient discharged from the Internal Medicine departments of hospitals in the Spanish Public Health Service between January 1st, 2005 and December 31st, 2008
After analyzing more than 2 million admissions, we found an incidence of hip fracture in patients admitted to internal medicine of 0.58 per 1000 admissions
Summary
The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Hip fracture in hospitalized patients has been related to a series of Patients admitted to internal medicine units have many of the factors associated with increased risk of falls and fractures during admission such as advanced age, mobility and cognitive impairment, confusional syndrome development during admission, polimedication and a high demand for nursing care [6]. The aim of the present study by the Internal Medicine Spanish Society Management Group was to analyze the incidence of hip fracture as a complication of admission to internal medicine units and to describe their epidemiological characteristics, including associated risk factors, hospital course, mortality, and impact on hospital stay and cost of care
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