ArticleThe Journal of the American Academy of Orthopaedic Surgeons2019
Predictive Modeling for Geriatric Hip Fracture Patients: Early Surgery and Delirium Have the Largest Influence on Length of Stay.
Article in The Journal of the American Academy of Orthopaedic Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Effectiveness of Perioperative Comprehensive Evaluation of Hip Fracture in the Elderly.Computational intelligence and neuroscience · 2022Trial
- Association between preoperative prognostic nutritional index and postoperative delirium in older adults with hip fractures: a real-world study.Annals of medicine · 2026Article
- Dexmedetomidine mitigates postoperative delirium after hip fracture surgery in elderly patients by modulating miR-107 expression.Journal of orthopaedic surgery and research · 2026Article
- Preoperative lactate-to-albumin ratio and risk of postoperative delirium after cardiac surgery in older adults: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- Sarcopenia is a risk factor for postoperative delirium in geriatric hip fracture patients: a retrospective study.Frontiers in medicine · 2024Article
- Machine learning applications for the prediction of extended length of stay in geriatric hip fracture patients.World journal of orthopedics · 2023Article
- SF-36 physical function and general health domains are independent predictors of acute hospital length of stay after hip fracture surgery.Musculoskeletal surgery · 2023Article
- Risk Factors and Outcomes of Extended Length of Stay in Older Adults with Intertrochanteric Fracture Surgery: A Retrospective Cohort Study of 2132 Patients.Journal of clinical medicine · 2022Article
- Review of Postoperative Delirium in Geriatric Patients After Hip Fracture Treatment.Geriatric orthopaedic surgery & rehabilitation · 2022Review
- Postoperative delirium in geriatric patients with hip fractures.Frontiers in aging neuroscience · 2022Review
- Post-operative delirium in the patient with hip fracture: The journey from hospital arrival to discharge.Frontiers in medicine · 2022Review
- The Impact of the Fascia Iliaca Block Beyond Perioperative Pain Control in Hip Fractures: A Retrospective Review.Geriatric orthopaedic surgery & rehabilitation · 2022Article
- Definition of patient complexity in adults: A narrative review.Journal of multimorbidity and comorbidity · 2022Review
- Risk Factors Associated With Extended Length of Hospital Stay After Geriatric Hip Fracture.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021Article
- Implementing a Geriatric Fracture Program in a Mixed Practice Environment Reduces Total Cost and Length of Stay.Geriatric orthopaedic surgery & rehabilitation · 2021Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundAveraging length of stay (LOS) ignores patient complexity and is a poor metric for quality control in geriatric hip fracture programs. We developed a predictive model of LOS that compares patient complexity to the logistic effects of our institution's hip fracture care pathway.
methodsA retrospective analysis was performed on patients enrolled into a hip fracture co-management pathway at an academic level I trauma center from 2014 to 2015. Patient complexity was approximated using the Charlson Comorbidity Index and ASA score. A predictive model of LOS was developed from patient-specific and system-specific variables using a multivariate linear regression analysis; it was tested against a sample of patients from 2016.
resultsLOS averaged 5.95 days. Avoidance of delirium and reduced time to surgery were found to be notable predictors of reduced LOS. The Charlson Comorbidity Index was not a strong predictor of LOS, but the ASA score was. Our predictive LOS model worked well for 63% of patients from the 2016 group; for those it did not work well for, 80% had postoperative complications. DISCUSSION: Predictive LOS modeling accounting for patient complexity was effective for identifying (1) reasons for outliers to the expected LOS and (2) effective measures to target for improving our hip fracture program. LEVEL OF EVIDENCE: III.
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