Morbidity and Mortality Associated with XXXX : A Medicare Part A Claims Database Analysis.

@entity1 @entity1171 @entity173 @entity174
BACKGROUND: The purpose of this study was to examine the incidence of adverse events in elderly @entity1 who required inpatient admission after sustaining an @entity1171 and to consider these data in relation to @entity173 and other geriatric @entity1 admissions. METHODS: A retrospective cohort study of @entity1 admitted with an @entity1171 , a @entity173 , or any other diagnosis was performed with the Medicare Part A database for 2008. The primary outcome measure was the one-year mortality rate, examined with multivariate analysis factoring for both @entity1 age and preexisting comorbidity. Secondary outcome measures analyzed additional morbidity as reflected by length of stay, discharge disposition, readmissions, and medical complications. RESULTS: There were 19,648 @entity1 with @entity1171 , 193,980 @entity1 with @entity173 , and 5,801,831 @entity1 with other admitting diagnoses. Significant differences (p < 0.001) were noted in both age and comorbidity status between the group with @entity1171 and the group with @entity173 . The one-year mortality after admission was 11.9% for @entity1 with @entity1171 , 28.2% for @entity1 with @entity173 , and 21.5% for @entity1 with any other admission. Upon using multivariate analysis to account for both age and comorbidity, the hazard ratio for one-year mortality associated with @entity174 was 1.088 for @entity1 with @entity173 and 0.557 for @entity1 with @entity1171 . CONCLUSIONS: Even after selecting for admitted @entity1 and accounting for both age and comorbidity, geriatric @entity1 with @entity1171 were found to have a lower one-year morbidity compared with geriatric @entity1 who had sustained a @entity173 or alternative admitting diagnoses. Geriatric @entity1 with @entity1171 are likely healthier and more active in ways that are not captured by simply accounting for age and comorbidity. These findings may support more aggressive definitive management of such injuries in this population. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
