(Research Hub Theater) Poor Outcomes Following Hip Dislocation for Patients with Preexisting Comorbidities

Background and/or Objectives: As the median age of our population rises, hip dislocations are becoming increasingly common. Rehabilitation can be challenging for some patients, and preexisting comorbidities may further complicate recovery and rehabilitation interventions. This study aims to determine the impacts of preexisting comorbidities on outcomes including length of hospital stay, ICU days, and discharge to rehabilitation facilities following hip dislocation.

Design: The National Trauma Data Bank (NTDB) was used to assess the length of hospital stay and discharge disposition for patients presenting with hip dislocation. Data regarding demographics, injury parameters, comorbidities, and Injury Severity Scores were extracted. Descriptive analysis and odds ratio were performed to assess the impact of comorbidities on hospital length of stay (LOS), ICU days, and discharge disposition to acute or long-term rehabilitation or discharge home without services.

Setting: Retrospective study of the NTDB from 2007-2015.

Participants: 3,271 patients with hip dislocations in the NTDB. Patients with hip dislocations following mild and moderate trauma as defined by the Injury Severity Scores were included in the analysis.

Interventions: not applicable.

Main Outcome Measures: The main outcome measures were LOS, ICU days, and discharge disposition.

Results: Obesity (11.80 v.s 7.85 p= <.001), alcohol (9.32 v.s 7.38 p=.002), diabetes (10.00 v.s 8.00 p=.02), and hypertension (9.13 v.s 7.89 p=.02), all had significantly longer LOS than patients without those comorbidities. These trends extended to ICU stays as well, most notably for obesity (2.91 v.s 0.92 p= <.001). Obese patients (OR=4.29) and diabetic patients (OR=2.88) had higher odds for rehab admittance.

Conclusions: Patients with at least one comorbid condition in conjunction with hip dislocation report longer LOS compared to patients without these conditions. Patients who reported alcoholism or obesity had a significantly longer LOS and ICU stay. Patients with obesity, alcohol use, diabetes, and hypertension had significantly greater odds of being discharged into rehabilitation than home discharge.