Patterns of discharge location may be evident based on the â??sicknessâ? profile of the patient. This study sought to evaluate the\nability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge\nlocation in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates.\nLow-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization. On initial\nevaluation in the Emergency Department, each patientâ??s age, comorbidities, injury severity, and functional status were utilized\nto calculate a STTGMA score. Discharge location was recorded with the primary outcome measure of an unsuccessful discharge\nbeing readmission within 30 days. Patients were risk stratified into minimal-, low-, moderate-, and high-risk STTGMA cohorts. A\np-value of <0.05 was considered significant for all statistical tests. 408 low-energy hip fractures were enrolled in the study with\na mean age of 81.3Â}10.6 years. There were 214 (52.5%) intertrochanteric fractures, 167 (40.9%) femoral neck fractures, and 27\n(6.6%) subtrochanteric femur fractures.There was no difference in readmission rates within STTGMA risk cohorts with respect to\ndischarge location; however, among individual discharge locations there was significant variation in readmission rateswhen patients\nwere risk stratified. Overall, STTGMA risk cohorts appeared to adequately risk-stratify readmission with 3.5% of minimal-risk\npatients experiencing readmission compared to 24.5% of moderate-risk patients. Specific cohorts deemed high-risk for readmission\nwere adequately identified.TheSTTGMAtool allows for prediction of unfavorable discharge location in hip fracture patients. Based\non observations made via the STTGMA tool, improvements in discharge planning can be undertaken to increase home discharge\nand to more closely track â??high-riskâ? discharges to help prevent readmissions.
Loading....