Predictors of Exceeding Target Inpatient Rehabilitation Length of Stay After Hip Fracture
Natalie Daly, Christian D. Fortin, Susan Jaglal, Shannon L. MacDonald
Abstract
OBJECTIVE: The aim of the study was to identify factors associated with exceeding a target inpatient rehabilitation length of stay of 28 days or less for individuals with hip fracture. DESIGN: 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 after 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. RESULTS: Four hundred ninety-three subjects were included in the analysis. Three hundred forty-five (70%) met and 148 (30%) exceeded their target length of stay. Patients who exceeded their target were more likely to be elderly (odds ratio, 1.05; 95% confidence interval, 1.02-1.08), to live alone prefracture (odds ratio, 1.72; 95% confidence interval, 1.02-2.91), to have dementia (odds ratio, 2.79; 95% confidence interval, 1.12-6.97), and higher admission pain scores (severe pain odds ratio, 2.51; 95% confidence interval, 1.06-5.93). Higher admission motor Functional Independence Measure scores (odds ratio, 0.95; 95% confidence interval, 0.92-0.98) were protective. CONCLUSIONS: Advancing age, having dementia, living alone prefracture, 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 also was associated with an overall increase in length of stay. Conversely, having a higher admission motor Functional Independence Measure score was protective.