• Jesper Lütkemeyer Kjeldsen
Background: Several patient, surgeon and health system risk factors have been associated with outcomes like mortality, length of stay and reoperations in previous literature. Yet, some risk factors are still being investigated in regards to their ability to predict certain outcomes and others are still not investigated. This study’s aims were to investigate and identify existing as well as new risk factors, which may be used as predictors for mortality, length of stay and reoperations. Method: A cohort study was designed with screening of all orthopedic patients admitted to Aalborg University Hospital from 1st August 2014 – 31th of October 2014. Only patients who underwent orthopedic surgery and who we could follow-up 3 months after the inclusion period were included in the study. Demographic and clinical patient data were collected during the inclusion and follow-up period by use of the internal hospital journal software Clinical Suite. Patient variables collected were: Gender, age (years), BMI (kg/m2), admission type (acute/elective), Charlson Index score, diagnose type (hip fracture/other orthopedic diagnose), time to surgery (days), operation time (minutes), reoperation, prescribed rehabilitation plan, early rehabilitation, length of stay (days), 90-days mortality and comorbidities (heart disease, arrhyth-mia, hypertension, diabetes, chronic obstructive pulmonary disease, hypercholesterolemia, kidney insufficiency, neurological disease, history of apoplexy, depression). The outcome variables, mor-tality, length of stay and reoperations, were analyzed by multiple- and logistic regression. Results: Nine hundred and seventy patients were admitted in the inclusion period, of these 663 patients were included in the study. Rehabilitation plan (p < .05), Charlson Index score > 3 (p < .001), age (p < .05) and history of apoplexy (p < .05) were significant predictors of 90-days mortality. Hip fracture (p < .05), operation time (p < .001), age (p < .05) and diabetes (p < .001) were significant predictors of prolonged length of stay. Lastly, elective admission (p < .05), depresssion (p < .05) and kidney insufficiency (p < .05) were significant predictors of reoperation. Conclusion: Charlson Index score > 3, increased age and a history of apoplexy are potential predictors for increased risk of 90-days mortality. Patients prescribed a rehabilitation plan have a decreased risk of 90-days mortality. Patients having either hip fracture, long operation time, increased age or diabetes may be at risk for prolonged length of stay. Having depression, kidney insufficiency or being electively admitted may predict the occurrence of reoperation.
LanguageEnglish
Publication date29 May 2015
Number of pages16
External collaboratorAalborg Universitets Hospital Syd
Overlæge Sten Rasmussen sten@hst.aau.dk
Other
ID: 213141341