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Journal Article

Citation

Cabalatungan S, Divaris N, McCormack JE, Huang EC, Kamadoli R, Abdullah R, Vosswinkel JA, Jawa RS. J. Surg. Res. 2018; 232: 257-265.

Affiliation

Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York. Electronic address: randeep.jawa@stonybrookmedicine.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jss.2018.06.054

PMID

30463726

Abstract

INTRODUCTION: Isolated hip fracture (IHF) is a common injury in the elderly after a fall. However, there is limited study on elderly IHF patients' subsequent hospitalization for a new injury, that is, trauma-related recidivism.

METHODS: A retrospective review of the trauma registry at an ACS level I trauma center was performed for all elderly (age ≥ 65 y) blunt trauma patients admitted between 2007 and 2017, with a focus on IHF patients. IHF was defined as a fracture of the femoral head, neck, and/or trochanteric region without any other injuries except minor soft tissue trauma after a fall.

RESULTS: Of the 4986 elderly blunt trauma admissions, 974 (19.5%) had an IHF. The rate of trauma-related recidivism was 8.9% (n = 87) for a second injury requiring hospitalization. The majority of recidivist (74.7%) and nonrecidivist (66.5%) patients were females. Hospital length of stay was similar at index admission (7 d for recidivists versus 8 d for nonrecidivists). The median interval between index hospitalization and admission for a second injury was 373 d (IQR 156-1002). The most common mechanism of injury at index admission (95.4%) and at second injury-related hospitalization (95.4%) was a low-level fall. Among recidivist patients at second admission, a second hip fracture was present in 34.5% and intracranial hemorrhage in 17.2%.

CONCLUSIONS: After initial admission for an IHF, 8.9% of patients were readmitted for a second injury, at a median time of approximately 1 y, overwhelmingly from a low-level fall. Emphasis on fall prevention programs and at index admission is recommended.

Copyright © 2018 Elsevier Inc. All rights reserved.


Language: en

Keywords

Blunt trauma; Elderly; Hip fracture; Outcomes; Recidivism; Second injury; Trauma

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