Determinants of length of stay after first admission for osteoporotic proximal femoral fracture in Japan.

Abstract

Introduction: Osteoporotic proximal femoral fractures (OPFFs) are among the top 10 causes of adult disability and are one of the four major conditions alongside dementia, stroke, and frailty that require nursing care in Japan. With the aging Japanese population, the incidence of these fractures is expected to increase.

Materials and methods: This retrospective, cross-sectional study analyzed data from the Diagnosis Procedure Combination database in Japan, focusing on hospital stays for OPFFs. Patients aged ≥60 years who underwent surgery during their first hospitalization between April 2008 and December 2020 were included. Logistic regression and decision tree models were used to identify factors associated with length of hospital stay.

Results: Among the 338,358 patients identified, 197,936 aged ≥60 years underwent surgery, with a median stay of 27 days. Most patients were women (n = 154,537) with a median age of 85 years. The hospitals with ≥500 beds are more likely to have shorter stays (less than 23 days) compared to hospitals with ≤199 beds (odds ratio, 0.19; 95 % CI, 0.18-0.20).

Conclusion: The number of available hospital beds is more related to length of hospitalization for OPFFs than comorbidities. Hospitals with a large number of beds are associated with significantly shorter hospital stays. In an aging society, reducing the length of hospitalization for OPFFs, an injury whose incidence is expected to increase, is a crucial step toward improving healthcare efficiency and economic stability.