Discharge destination and patient-reported outcomes after inpatient treatment for isolated lower limb fractures.
Adolescent
Adult
Australia
/ epidemiology
Female
Fractures, Bone
/ therapy
Hospitalization
/ statistics & numerical data
Humans
Lower Extremity
/ injuries
Male
Middle Aged
Odds Ratio
Patient Discharge
/ statistics & numerical data
Patient Reported Outcome Measures
Propensity Score
Prospective Studies
Recovery of Function
Registries
Rehabilitation Centers
/ statistics & numerical data
Return to Work
/ statistics & numerical data
Treatment Outcome
Young Adult
Fractures, bone
Orthopedic procedures
Rehabilitation
Trauma surgery
Treatment outcome
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
09
06
2019
accepted:
30
10
2019
pubmed:
6
2
2020
medline:
14
7
2020
entrez:
5
2
2020
Statut:
ppublish
Résumé
To examine the association between discharge destination (home or inpatient rehabilitation) for adult patients treated in hospital for isolated lower limb fractures and patient-reported outcomes. Review of prospectively collected Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) data. Adults (18-64 years old) treated for isolated lower limb fractures at four Melbourne trauma hospitals that contribute data to the VOTOR, 1 March 2007 - 31 March 2016. Return to work and functional recovery (assessed with the extended Glasgow Outcomes Scale, GOS-E); propensity score analysis of association between discharge destination and outcome. Of 7961 eligible patients, 1432 (18%) were discharged to inpatient rehabilitation, and 6775 (85%) were followed up 12 months after their injuries. After propensity score adjustment, the odds of better functional recovery were 56% lower for patients discharged to inpatient rehabilitation than for those discharged directly home (odds ratio, 0.44; 95% CI, 0.37-0.51); for the 5057 people working before their accident, the odds of return to work were reduced by 66% (odds ratio, 0.34; 95% CI, 0.26-0.46). Propensity score analysis improved matching of the discharge destination groups, but imbalances in funding source remained for both outcome analyses, and for also for site and cause of injury in the GOS-E analysis (standardised differences, 10-16%). Discharge to inpatient rehabilitation after treatment for isolated lower limb fractures was associated with poorer outcomes than discharge home. Factors that remained unbalanced after propensity score analysis could be assessed in controlled trials.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
263-270Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 AMPCo Pty Ltd.
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