@article{48d50c2ecb354dd79a35b30556503d15,
title = "Nutritional markers may identify patients with greater risk of re-admission after geriatric hip fractures",
abstract = "Purpose: Osteoporotic hip fractures are increasing in prevalence with the growing elderly population. Morbidity and mortality remain high following osteoporotic hip fractures despite advances in medical and surgical treatments. The associated costs and medical burdens are increased with a re-admission following hip fracture treatment. This study sought to identify demographic and clinical values that may be a predictive model for 30-day re-admission risk following operative management of an isolated hip fracture. Methods: Between January 1, 2013 and April 30, 2015 all patients admitted to a single academic medical centre for treatment of a hip fracture were reviewed. Candidate variables included standard demographics, common laboratory values, and markers of comorbid conditions and nutrition status. A 30-day, all-cause re-admission model was created utilizing multivariate logistic regression. Results: A total of 607 patients with hip fractures were identified and met the inclusion criteria; of those patients, 67 were re-admitted within 30 days. Univariate analysis indicates that the re-admission group had more comorbidities (p < 0.001) and lower albumin (p = 0.038) and prealbumin (p < 0.001). The final, reduced model contained 12 variables and incorporated four out of five nutritional makers with an internally, cross-validated C-statistic of 0.811 (95% CI: 0.754, 0.867). Conclusion: Our results indicate that specific nutritional laboratory markers at the index admission may identify patients that have a greater risk of re-admission after hip fracture. This model identifies potentially modifiable risk factors and may allow orthogeriatricians to better educate patients and better treat post-operative nutritional status and care.",
keywords = "Electronic medical records, Hip fracture, Prediction, Re-admission, Risk factors",
author = "Stone, {Austin V.} and Alexander Jinnah and Wells, {Brian J.} and Hal Atkinson and Miller, {Anna N.} and Futrell, {Wendell M.} and Kristin Lenoir and Emory, {Cynthia L.}",
note = "Funding Information: Conflict of interest Dr. Stone has received research support from Smith & Nephew. Dr. Miller has received financial support from AO North America. Dr. Miller is a board or committee member for the American Academy of Orthopedic Surgery, the American College of Surgeons, the AOTrauma North America, and the Orthopedic Trauma Association. Dr. Miller is also on the editorial or governing board for the Journal of Orthopedic Trauma. Dr. Emory is a paid consultant for BoardVitals. Dr. Emory receives research support from IlluminOss Medical and the Muskuloskeletal Transplant Foundation. Dr. Emory is a board or committee member for the Ruth Jackson Orthopedic Society. Dr. Jinnah, Dr. Wells, Dr. Atkinson, Ms. Lenoir, and Mr. Futrell declare they have no conflicts of interest. Funding Information: The authors would like to thank Jan Lawlor, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, for her assistance with research coordination. The authors would also like to acknowledge the data extraction and statistical assistance of the Wake Forest Clinical and Translational Science Institute (WF CTSI), which is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001420. Dr. Stone has received research support from Smith & Nephew. Dr. Miller has received financial support from AO North America. Dr. Miller is a board or committee member for the American Academy of Orthopedic Surgery, the American College of Surgeons, the AOTrauma North America, and the Orthopedic Trauma Association. Dr. Miller is also on the editorial or governing board for the Journal of Orthopedic Trauma. Dr. Emory is a paid consultant for BoardVitals. Dr. Emory receives research support from IlluminOss Medical and the Muskuloskeletal Transplant Foundation. Dr. Emory is a board or committee member for the Ruth Jackson Orthopedic Society. Dr. Jinnah, Dr. Wells, Dr. Atkinson, Ms. Lenoir, and Mr. Futrell declare they have no conflicts of interest. Funding Information: Acknowledgements The authors would like to thank Jan Lawlor, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, for her assistance with research coordination. The authors would also like to acknowledge the data extraction and statistical assistance of the Wake Forest Clinical and Translational Science Institute (WF CTSI), which is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001420. Publisher Copyright: {\textcopyright} 2017, SICOT aisbl.",
year = "2018",
month = feb,
day = "1",
doi = "10.1007/s00264-017-3663-3",
language = "English",
volume = "42",
pages = "231--238",
journal = "International Orthopaedics",
issn = "0341-2695",
number = "2",
}