Predicting discharge destination of community-dwelling elderly undergone hip fracture operation in United Christian Hospital

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Authors (including presenting author) :
Kwok WY(1), Wong KK(1), Wan SH(1), Au KM(2), Kwok WL(3)
Affiliation :
(1)Occupational Therapy Department, United Christian Hospital (2)Occupational Therapy Department, Tai Po Hospital (3)Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong
Introduction :
The number of hip fracture patients is growing. Majority of the researches on hip fracture focuses on the management aspects, mortality, morbidity and post-injury mobility status or activity of daily living status. Limited researches have used the discharge destination of patients following hip fracture as an outcome measure. Early identification of the discharge location of hip fracture patients allows the social arrangement to be made earlier and reduces the avoidable delays in discharge.
Objectives :
To predict on admission, the discharge destination in community-dwelling elderly patients following hip fracture.
Methodology :
A total 346 patients were included in this study.Data were retrospectively identified through the Clinical Data Analysis and Reporting System and the Clinical Management System. The outcome measure was whether the patient was discharged from hospital to home, rehabilitation hospital or old-aged home. Risk factors influencing the discharge destination were identified using univariate analysis and then multinomial logistic regression analysis.
Result & Outcome :
Univariate analysis revealed that age, gender, premorbid living status, premorbid mobility, premorbid ADL function, cognitive function upon admission and comorbidities of renal impairment and dementia had a significant effect. Predictors of discharge to rehabilitation hospital: Increasing age (OR=1.07), male gender (OR=2.43), living alone (OR=2.68), independent walker before admission (OR=4.14), dementia (OR=2.35) and renal impairment (OR=8.58) Predictors of discharge to old aged home: Increasing age (OR=1.15), living alone (OR=5.95), independent walker before admission (OR=11.13), assisted or dependent in ADL before admission (OR=5.29) and dementia (OR=3.68) Common predictors of discharge to alternative location: Increasing age, living alone, independent walker before admission and dementia.

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