Tohoku J. Exp. Med., 2019 January, 247(1)

Determinants Associated with Prolonged Hospital Stays for Patients Aged 65 Years or Older with a Vertebral Compression Fracture in a Rural Hospital in Japan

YUSUKE WATANABE,1 SHIZUKIYO ISHIKAWA,2 HIROYUKI NAGATA1 and MASAYUKI KOJIMA3

1Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, Hitachiomiya, Ibaraki, Japan
2Medical Education Center, Jichi Medical University, Shimotsuke, Tochigi, Japan
3Department of Surgery, Hitachiomiya Saiseikai Hospital, Hitachiomiya, Ibaraki, Japan

Japan is an aging society, and the incidence of diseases related to aging, such as pneumonia, heart failure, vertebral compression fracture (VCF), is increasing. Prolonged hospital stays are becoming a serious social problem, leading to elevated medical expenses. Thus, shortening the period of hospitalization is important. This study aimed to reveal determinants associated with prolonged hospital stays for patients with VCF. Our institution is the primary hospital in a rural area in the Kanto region of Japan. Altogether, 110 patients with a VCF, aged 65 years or older, including 79 women, were divided into two groups according to the average hospital stay period of 28 days: the long-stay group (mean stay 40.0 ± 11.6 days, n = 39) and the short-stay group (mean stay 20.6 ± 4.4 days, n = 71). Notably, the short-stay group included 55 women. Multivariate logistic regression analyses in male showed no variates significantly associated with prolonged hospitalization. By contrast, multivariate logistic regression analyses in female showed requiring emergency transportation to hospital was significantly associated with prolonged hospitalization [odds ratio 7.69, 95% confidence interval 1.13-52.29, P = 0.04]. In conclusion, this study implies that patients with better levels of activities of daily living are able to walk alone sooner and are easily discharged. Furthermore, the patient requiring emergency transportation might be in a poor social living environment, such as living alone. These results may give us a good opportunity to re-consider fundamental problems surrounding the elderly.

keywords —— activities of daily living; determinant; elderly patients; long hospital stay; vertebral compression fracture

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Tohoku J. Exp. Med., 2019, 247, 27-34

Correspondence: Yusuke Watanabe, M.D., Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, 3033-3 Tagouchi-cho, Hitachiomiya, Ibaraki 319-2601, Japan.

e-mail: m04100yw@jichi.ac.jp