Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA)
Patterns of discharge location may be evident based on the “sickness” profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/9793435 |
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| author | Sanjit R. Konda Hesham Saleh Ariana Lott Kenneth A. Egol |
| author_facet | Sanjit R. Konda Hesham Saleh Ariana Lott Kenneth A. Egol |
| author_sort | Sanjit R. Konda |
| collection | DOAJ |
| description | Patterns of discharge location may be evident based on the “sickness” profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization. On initial evaluation in the Emergency Department, each patient’s age, comorbidities, injury severity, and functional status were utilized to calculate a STTGMA score. Discharge location was recorded with the primary outcome measure of an unsuccessful discharge being readmission within 30 days. Patients were risk stratified into minimal-, low-, moderate-, and high-risk STTGMA cohorts. A p-value of <0.05 was considered significant for all statistical tests. 408 low-energy hip fractures were enrolled in the study with a mean age of 81.3±10.6 years. There were 214 (52.5%) intertrochanteric fractures, 167 (40.9%) femoral neck fractures, and 27 (6.6%) subtrochanteric femur fractures. There was no difference in readmission rates within STTGMA risk cohorts with respect to discharge location; however, among individual discharge locations there was significant variation in readmission rates when patients were risk stratified. Overall, STTGMA risk cohorts appeared to adequately risk-stratify readmission with 3.5% of minimal-risk patients experiencing readmission compared to 24.5% of moderate-risk patients. Specific cohorts deemed high-risk for readmission were adequately identified. The STTGMA tool allows for prediction of unfavorable discharge location in hip fracture patients. Based on observations made via the STTGMA tool, improvements in discharge planning can be undertaken to increase home discharge and to more closely track “high-risk” discharges to help prevent readmissions. |
| format | Article |
| id | doaj-art-5afcf7ea9d0a474a8b206077f1232176 |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-5afcf7ea9d0a474a8b206077f12321762025-02-03T01:31:47ZengWileyAdvances in Orthopedics2090-34642090-34722018-01-01201810.1155/2018/97934359793435Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA)Sanjit R. Konda0Hesham Saleh1Ariana Lott2Kenneth A. Egol3Department of Orthopedic Surgery, NYU Langone Medical Center, 301 East 17th Street, New York, NY 10003, USADepartment of Orthopedic Surgery, NYU Langone Medical Center, 301 East 17th Street, New York, NY 10003, USADepartment of Orthopedic Surgery, NYU Langone Medical Center, 301 East 17th Street, New York, NY 10003, USADepartment of Orthopedic Surgery, NYU Langone Medical Center, 301 East 17th Street, New York, NY 10003, USAPatterns of discharge location may be evident based on the “sickness” profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization. On initial evaluation in the Emergency Department, each patient’s age, comorbidities, injury severity, and functional status were utilized to calculate a STTGMA score. Discharge location was recorded with the primary outcome measure of an unsuccessful discharge being readmission within 30 days. Patients were risk stratified into minimal-, low-, moderate-, and high-risk STTGMA cohorts. A p-value of <0.05 was considered significant for all statistical tests. 408 low-energy hip fractures were enrolled in the study with a mean age of 81.3±10.6 years. There were 214 (52.5%) intertrochanteric fractures, 167 (40.9%) femoral neck fractures, and 27 (6.6%) subtrochanteric femur fractures. There was no difference in readmission rates within STTGMA risk cohorts with respect to discharge location; however, among individual discharge locations there was significant variation in readmission rates when patients were risk stratified. Overall, STTGMA risk cohorts appeared to adequately risk-stratify readmission with 3.5% of minimal-risk patients experiencing readmission compared to 24.5% of moderate-risk patients. Specific cohorts deemed high-risk for readmission were adequately identified. The STTGMA tool allows for prediction of unfavorable discharge location in hip fracture patients. Based on observations made via the STTGMA tool, improvements in discharge planning can be undertaken to increase home discharge and to more closely track “high-risk” discharges to help prevent readmissions.http://dx.doi.org/10.1155/2018/9793435 |
| spellingShingle | Sanjit R. Konda Hesham Saleh Ariana Lott Kenneth A. Egol Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) Advances in Orthopedics |
| title | Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) |
| title_full | Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) |
| title_fullStr | Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) |
| title_full_unstemmed | Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) |
| title_short | Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) |
| title_sort | predicting discharge location among low energy hip fracture patients using the score for trauma triage in the geriatric and middle aged sttgma |
| url | http://dx.doi.org/10.1155/2018/9793435 |
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