Hip Fracture Patients Often Have Other Health Problems

They contribute to lengthier hospital stays, researchers say

MONDAY, Jan. 23 (HealthDay News) -- Weight loss and malnutrition are among the medical conditions that increase treatment costs and the length of hospital stays for older adults with hip fractures, a new study finds.

More than 250,000 hip fractures occur each year in the United States, often resulting in hospitalization, surgery, extended periods of rehabilitation and/or long-term disability, and admission to a nursing home.

This study looked at coexisting medical conditions (comorbidities) that affect treatment costs and the length of hospitalization for hip fracture patients. The researchers examined 2007 hospital discharge data from 32,440 patients treated at more than 1,000 hospitals in 40 states. Nearly 80 percent of the patients were 75 or older and 72 percent were women.

Most of the patients had two or three comorbidities. Only about 5 percent had no other health conditions. High blood pressure affected 67 percent of the patients and was by far the most common comorbid condition.

Other comorbidities included: deficiency anemias (disorders caused by a lack of certain nutrients, such as iron or vitamin B12); fluid and electrolyte disorders; chronic lung diseases; diabetes; neurological disorders; hypothyroidism; and congestive heart failure.

The researchers found that comorbidities significantly increase treatment cost and length of hospital stay. Hip fracture patients who were very thin or malnourished had the greatest increased costs, following by those with pulmonary circulatory disorders that affect blood flow to and from the lungs.

Recent weight loss or malnutrition also had the greatest impact on hospitalization, increasing the length of hospital stay by 2.5 days. Hospital stays were about a day longer for patients with congestive heart failure or pulmonary circulation disorders.

Other comorbidities that lengthened hospital stay were fluid and electrolyte disorders, paralysis, and conditions contributing to blood clots.

The study was published in the Journal of Bone and Joint Surgery.

Two major issues require further investigation, according to Dr. Kevin Black, one of the study authors and professor and chair of orthopedics and rehabilitation at Penn State College of Medicine.

"First, we need to better understand the total cost of caring for hip-fracture patients. Our study focused only on acute hospitalization, but care typically extends well beyond this, since many patients are discharged to rehabilitation and skilled-nursing facilities," Black said in a journal news release.

"Second, this study did not investigate the quality or outcomes of care. As our population ages, there is reason to believe that the number of hip fractures will increase. Having a better understanding of the comorbidities that affect hip-fracture patients hopefully will lead to the development of strategies to more effectively care for these patients."

More information

The U.S. Centers for Disease Control and Prevention has more about hip fractures among older adults.

Robert Preidt SOURCE: Journal of Bone and Joint Surgery, news release, Jan. 18, 2012

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