Determinants of Length of Hospital Stay in Older Adult Hip Fracture Patients in a Northern Peruvian Hospital

<b>Background/Objectives:</b> Hip fracture is a condition with increasing hospital demand, and the determinants of hospital stay are crucial for improving clinical outcomes and costs in this vulnerable population. To establish the determinants of the length of hospital stay (HS) of older adult patients with hip fractures in a hospital in the Lambayeque region of Peru during 2017-2019. <b>Methods:</b> We conducted an observational study based on a secondary data analysis. The outcome variable was HS, measured in terms of days from admission to the hospitalization unit until discharge. The main independent variables were age, functional ambulation category scale, cognitive status index (Mental Red Cross scale), Barthel index, comorbidities, geriatric syndromes, trauma diagnosis, reason for surgical delay, preoperative time and preoperative complications. We performed a Poisson or negative binomial regression through crude and adjusted models. <b>Results:</b> Of 399 patients, the average age was 82.25 years, with 63.7% being female. A Poisson and negative binomial regression analysis were conducted for the variables that were significant in the crude model, which were sex, multimorbidity, mental Red Cross scale, Barthel index, functional ambulation, number of geriatric syndromes, traumatic diagnosis, reason for delay in the first model, preoperative complications in the first model, emergency stay, and preoperative time in the second model. According to the adjusted model, the analysis found that in the first model, advanced dementia as measured by the Mental Red Cross (MRC) scale was associated with an increase in hospital length of stay (IRR = 1.82, 95% CI = 1.03-3.23, <i>p</i> < 0.04); similarly, having preoperative complications increased hospital length of stay (IRR = 1.56, 95% CI = 1.30-1.86, <i>p</i> < 0.001), adjusted for clinical variables; in the second model, preoperative time was associated with an increase in hospital length of stay (IRR = 7.44, 95% CI = 6.96-7.96, <i>p</i> < 0.001), adjusted for emergency department stay. A third global model was developed, finding that advanced dementia as measured by the MRC (IRR = 1.82, 95% CI = 1.02-3.23, <i>p</i> < 0.04) and the presence of preoperative complications (IRR = 1.56, 95% CI = 1.30-1.86, <i>p</i> < 0.04) were associated with increased hospital length of stay, adjusted for clinical and hospital variables. <b>Conclusions:</b> The average HS of older adult hip fracture patients treated at a tertiary hospital in the Lambayeque region of Peru was 17 days. The main determinants of HS duration were advanced dementia and presence of preoperative complications.

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Journal
Journal of Clinical Medicine
Published
2025-12-03
DOI
https://doi.org/10.3390/jcm14238564
Primary Topic
Hip and Femur Fractures
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article
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article

Determinants of Length of Hospital Stay in Older Adult Hip Fracture Patients in a Northern Peruvian Hospital

Mario Josué Valladares-Garrido, Jesús Manuel Verona Mendoza, Edwin Aguirre-Milachay, Darwin A. León‐Figueroa et al.
Journal of Clinical Medicine
Hip and Femur Fractures
article

Determinants of Length of Hospital Stay in Older Adult Hip Fracture Patients in a Northern Peruvian Hospital

Mario Josué Valladares-Garrido, Jesús Manuel Verona Mendoza, Edwin Aguirre-Milachay, Darwin A. León‐Figueroa, Bryam William Sarmiento Llaguenta
article en

Abstract

<b>Background/Objectives:</b> Hip fracture is a condition with increasing hospital demand, and the determinants of hospital stay are crucial for improving clinical outcomes and costs in this vulnerable population. To establish the determinants of the length of hospital stay (HS) of older adult patients with hip fractures in a hospital in the Lambayeque region of Peru during 2017-2019. <b>Methods:</b> We conducted an observational study based on a secondary data analysis. The outcome variable was HS, measured in terms of days from admission to the hospitalization unit until discharge. The main independent variables were age, functional ambulation category scale, cognitive status index (Mental Red Cross scale), Barthel index, comorbidities, geriatric syndromes, trauma diagnosis, reason for surgical delay, preoperative time and preoperative complications. We performed a Poisson or negative binomial regression through crude and adjusted models. <b>Results:</b> Of 399 patients, the average age was 82.25 years, with 63.7% being female. A Poisson and negative binomial regression analysis were conducted for the variables that were significant in the crude model, which were sex, multimorbidity, mental Red Cross scale, Barthel index, functional ambulation, number of geriatric syndromes, traumatic diagnosis, reason for delay in the first model, preoperative complications in the first model, emergency stay, and preoperative time in the second model. According to the adjusted model, the analysis found that in the first model, advanced dementia as measured by the Mental Red Cross (MRC) scale was associated with an increase in hospital length of stay (IRR = 1.82, 95% CI = 1.03-3.23, <i>p</i> < 0.04); similarly, having preoperative complications increased hospital length of stay (IRR = 1.56, 95% CI = 1.30-1.86, <i>p</i> < 0.001), adjusted for clinical variables; in the second model, preoperative time was associated with an increase in hospital length of stay (IRR = 7.44, 95% CI = 6.96-7.96, <i>p</i> < 0.001), adjusted for emergency department stay. A third global model was developed, finding that advanced dementia as measured by the MRC (IRR = 1.82, 95% CI = 1.02-3.23, <i>p</i> < 0.04) and the presence of preoperative complications (IRR = 1.56, 95% CI = 1.30-1.86, <i>p</i> < 0.04) were associated with increased hospital length of stay, adjusted for clinical and hospital variables. <b>Conclusions:</b> The average HS of older adult hip fracture patients treated at a tertiary hospital in the Lambayeque region of Peru was 17 days. The main determinants of HS duration were advanced dementia and presence of preoperative complications.

Journal of Clinical MedicineVol. 14(23)
Universidad de San Martín de Porres (PE), Hospital Nacional Cayetano Heredia (PE), Universidad Privada Sergio Bernales (PE), Universidad Señor de Sipán (PE)
Openalex Percentile: Top 42%
Hip and Femur Fractures
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