Predictors of Exceeding Target Inpatient Rehabilitation Length of Stay after Hip Fracture.Am J Phys Med Rehabil 2020AJ
To identify factors associated with exceeding a target inpatient rehabilitation length of stay of 28 days or less for individuals with hip fracture.
Retrospective cohort study of hip fracture patients admitted to an urban Canadian inpatient rehabilitation facility between January 1, 2013 and January 1, 2018. Patient characteristics previously shown to be associated with individual outcomes and / or length of stay following hip fracture were extracted from the institution's data warehouse. Regression models were used to examine factors associated with exceeding target length of stay as well as overall length of stay.
493 subjects were included in the analysis. 345 (70%) met and 148 (30%) exceeded their target length of stay. Patients who exceeded their target were more likely to be elderly (OR 1.05, 95% CI 1.02-1.08), to live alone pre-fracture (OR 1.72, 95% CI 1.02-2.91), to have dementia (OR 2.79, 95% CI 1.12-6.97), and higher admission pain scores (severe pain OR 2.51, 95% CI 1.06-5.93). Higher admission motor FIM scores (OR 0.95, 95% CI 0.92-0.98) were protective.
Advancing age, having dementia, living alone pre-fracture, and reporting moderate or severe pain at the time of admission not only increased the odds of an individual exceeding their target length of stay, but was associated with an overall increase in length of stay. Conversely, having a higher admission motor FIM score was protective.