Hip Fractures in Veterans, Management & Characteristics

Kouser A, Budiman-Mak E, Weaver FM. Hip Fractures in Veterans, Management & Characteristics. Paper presented at: Society of General Internal Medicine Annual Meeting; 2002 Sep 26; Chicago, IL.

Our objectives are to compare the types of Hip Fracture(Hip FX) with regards to 1)Demographics 2)common Co Morbidities 3) length of stay( LOS) after surgery 4) mortality at 30 , 180 days post discharge 5) Readmissions within 30 and 180 days.Methods: This is a retrospective study of the inpatient database of the Veterans who were admitted to Hines Va hospital with a diagnosis of Hip FX during 1/1/90-12/31/97 .Fractures were grouped as femoral neck fracture(FNF) (820-820.19, 820.8, 820.9) or intertrochanteric fractures(IF)( 820.2-820.32).All the other types of Hip FX were grouped as the' Other' group (OT)LOS is defined as hospital stay from the date of surgery to the date of discharge mortality is defined as death occurring within 30, 180 and 365 days from the day of discharge .Readmission is defined as any hospital admission within 30 and 180 days from the time of discharge. Data collection procedure information was abstracted from databases, known as local VISTA (Veterans Health Information System and Technologies Architecture).Statistical analysis: Data was analyzed using SAS statistical package Version8.2.Descriptive statistics was used for continuous data, where as chi-square test was used for categorical data. Results : Of the 209 patients studied, predominantly patients were single (61.7%), white (89.5%) elderly males(95.2 %).The mean age was 73 SD 11.6.All of the fractures were closed (100%) Majority were IF(48.3%) .The 30 day mortality was slightly higher in the pts with FNF (3.35%)The most common co morbidity was Neurological disease(45%). The 30 and 180 day readmission rates were higher in the pts with IF (5.26%) and (11.48%). Most of the pts were treated with Open reduction and Internal fixation ( ORIF) ( 63.2%). Most of the pts were discharged other then their homes (78%)..The overall 30 day mortality was smaller then reported in other studies.Limitations there is a possibility that some data is missing. Miscoding might have occurred in administrative database clinical information was frequently unavailable. Some elderly veterans might have used non Va care. This was a predominantly male sample.