Differing risk factors for potentially preventable and fall-related injury readmissions of older residents in long-term care facilities after hip fracture

Background: Although most fall-related injury readmissions are preventable, there may be differences between risk factors for other potentially preventable readmissions (PPR) and fall-related injury readmissions. This study examined the differences between risk factors for 30-day PPR and fall-related injury readmissions among older adults living in residential aged care facilities (RACFs) after a hip fracture.

Methods: This retrospective cohort study used linked hospitalization and mortality data in New South Wales, Australia. Residents aged ≥65 years who live in RACFs and were admitted after a hip fracture between 2014 and 2023. Demographic data, the number of Charlson comorbidities, and frailty risk were used. The 30-day PPR was identified using 22 conditions as defined by the Australian government, and three additional conditions (pressure injury, dehydration, sepsis). Multivariable logistic regression examined the predictors for 30-day PPR and fall-related injury readmissions.

Results: Among 12,335 residents, there were 266 residents who experienced PPR, and 361 residents who experienced fall-related injury readmissions. Although residents with one (odds ratios: 1.98, 95 % confidence interval: 1.50-2.61) or ≥2 comorbidities (2.38, 1.67-3.37) had a higher risk of 30-day PPR than residents without comorbidities, there was no association of comorbidities with 30-day fall-related injury readmissions. Frailty risk was not associated with 30-day PPR, but residents with high (0.58, 0.37-0.92) and moderate frailty risk (0.63, 0.40-0.99) were less likely to experience fall-related injury readmissions than residents with no frailty risk.

Conclusions: Targeted approaches for 30-day PPR and fall-related injury readmissions should be optimized based on their specific predictors for preventing 30-day readmissions.