Correlations of hospital length of stay and mortality with the osteoporotic hip-fracture type, treatment, the sociodemographic and hospital variables

Introduction: Diseases related to the elderly, including osteoporosis and the resulting fractures have a high incidence and are characterized by a high risk of early death. Most hip fractures are treated surgically. Its cost projections vary widely depending on the region, the level of institutional care, and the surgical solutions used.

Material and method: We performed a retrospective study using hospital data from 2018-2019. The study included patients whose main diagnosis was: S72.0 - femoral neck fracture, S72.1 - pertrochanteric fracture, S72.2 - subtrochanteric fracture. We used hospital data from seven Romanian counties, Arad, Arges, Bucharest, Szilágy, Temes, Tulcea and Vaslui.

Results: Women were significantly more affected (68.3%) than men, however the risk of mortality was 1.7 times higher among men. The average age was 77.2 years, 86% of the patients were over 65 years old. Most patients (69.3% ) were urban residents, but they were also characterized by a higher LOS and mortality.

Discussion: Fracture types, gender distribution and correlation with urbanization of the fractures are consistent with international epidemiological data. Regression analysis shows a significant correlation between the length of hospital stay and the following variables: gender, environment, age, diagnosis, type of hospital and death. Regarding the average time of hospital stay, the shortest duration of hospitalization was in Vaslui and Tulcea (9.59 and 9.79 days), while the longest (13.42 and 14.61 days) were in Arad and Arges counties.

Conclusions: On average, the patient hospitalization time in the examined counties is higher (13 days) than the Romanian average (11 days). Mortality is significantly higher among men, urban residents and those who suffer subtrochanteric fractures. Regarding the costs per patient of fractures, it can be said that Arad is the most economical, while Salaj county is the least cost-effective.