The purpose of this study was to (1) identify trends in the rates of deep venous thrombosis (DVT) and pulmonary embolism (PE) and (2) calculate the additional incremental inpatient cost and length of stay associated with VTE following hip fracture surgery.
Retrospective database analysis SETTING:: Hospital discharge data PATIENTS/PARTICIPANTS:: A total of 838,054 patients undergoing operative treatment of hip fractures in the National Inpatient Sample from 2003-2014.
Internal fixation or partial/total hip replacement.
MAIN OUTCOME MEASUREMENTS:
The length of stay and cost of hospitalization were compared between patients with VTE and those without using a student’s t-test. A logistic regression model was performed to evaluate the trends in VTE rates and a multivariable linear regression model was performed to evaluate inpatient hospital costs.
The overall rates of DVT and PE were 0.3% and 0.53% respectively. VTE was associated with an increased length of stay (9 days versus 5 days) and increased inpatient cost ($103,860.83 versus $51,576.00). The rate of DVT over the study period decreased while the rate of PE increased.
Each episode of venous thromboembolism following hip fracture is a significant source of additional inpatient cost. Patients who sustain a VTE have approximately twice the length of stay and total inpatient cost as patients who do not. The rates of DVT following hip fracture surgery are decreasing while the rates of PE are increasing.
LEVEL OF EVIDENCE:
Prognostic Level III.