A recent study from the University of Rochester (N.Y.) Medical Center found shorter lengths of stay in the hospital were linked with lower mortality rates in hip fracture patients. These findings directly contradict a similar study conducted in Sweden in 2015.
Authors of the Swedish study reviewed nearly 120,000 hip fracture patients between 2006 and 2012 and concluded patients with shorter hospitalizations had an increased risk of death.
Intrigued by the study's findings, John C. Elfar, MD, associate professor in the URMC Department of Orthopaedics, conducted a study of his own. His team of URMC researchers built analytics software to mine New York's Statewide Planning and Research Cooperative System database, identifying a cohort of 188,208 hip fracture patients age 50 and older who were admitted to a New York hospital from 2000 to 2011.
Dr. Elfar found shorter lengths of stay were associated with lower 30-day mortality rates. Patients who were in the hospital between 11 and 14 days were 32 percent more likely to die within 30 days of discharge than patients who stayed one to five days. Additionally, the 30-day mortality risk rose 103 percent for patients who were in the hospital for two weeks or longer.
"Our analysis shows that the difference in hospital stays and results between Sweden and the U.S. is related to a difference in healthcare systems," said Dr. Elfar. "Patients do as well here with short hospital stays as they do with longer hospital stays in Sweden because U.S. hospitals focus on acute care and transfer patients to rehabilitation facilities as soon as possible. Such facilities are not available in Sweden, so patients rehab in the hospital setting and spend longer periods of time there."
Peter Nordstrom, MD, PhD, the author of the Swedish paper, reviewed URMC's findings and agreed with Dr. Elfar's conclusion.
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