Factors affecting hospital admission, hospital length of stay and new discharge destination post proximal humeral fracture: a retrospective audit

• Published in: BMC geriatrics Vol. 24; no. 1; p. 334
• Main Authors: McDonald, B R, Vogrin, S, Said, C M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12-04-2024; BioMed Central; BMC
• Subjects: Aged; Care and treatment; Comorbidity; Complications and side effects; Decision making; Dementia disorders; Demographic aspects; Discharge; Discharge planning; Female; Fractures; Hospital care; Hospitalization; Hospitals; Humans; Humerus; Length of Stay; Male; Medical diagnosis; Medical records; Older people; Osteoporosis; Patient Discharge; Patients; Prognosis; Proximal humeral fracture; Regression analysis; Retrospective Studies; Shoulder Fractures - epidemiology; Shoulder Fractures - therapy; Shoulder injuries; Statistical analysis; Australia; United States > US; Hospitalization; Proximal humeral fracture; Discharge; Length of stay
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-024-04928-z

Outcomes following proximal humeral fracture (PHF) may be impacted by a range of clinical, fracture and premorbid factors. The aim of this study was to examine factors impacting hospital admission; length of stay (LOS) and new discharge destination for patients presenting to hospital with PHF.
Retrospective audit conducted at a tertiary health service. Data was collected from adult patients presenting to hospital with a PHF over a 54-month period. Fractures that were pathological or sustained during admission were excluded. Univariable and multivariable logistic and negative binomial regression were used to explore factors associated with hospital admission, LOS and new discharge destination.
Data were analyzed from 701 participants (age 70 years (IQR 60, 81); 72.8% female); 276 (39.4%) participants required a hospital admission. New discharge destination was required for 109 (15.5%) participants, of whom 49 (45%) changed from home alone to home with family/friend(s). Greater comorbidities, as indicated by the Charlson Comorbidity Index score, were associated with hospital admission, longer LOS and new discharge destination. Premorbid living situations of home with family/friend(s) or from an external care facility were associated with a decreased likelihood of hospital admission, shorter LOS and reduced risk of a new discharge destination. Surgical treatment was associated with shorter LOS. Older age and dementia diagnosis were associated with a new discharge destination.
Many factors potentially impact on the likelihood or risk of hospitalization, LOS and new discharge destination post PHF. Patients with greater comorbidities are more likely to have negative outcomes, while patients who had premorbid living situations of home with family/friend(s) or from an external care facility are more likely to have positive outcomes. Early identification of factors that may impact patient outcomes may assist timely decision making in hospital settings. Further research should focus on developing tools to predict hospital outcomes in the PHF population.