Introduction our objective was to describe trends in returning home after hospitalisation for hip fracture and identify predictive factors of this important patient-focussed outcome. Methods a cohort of hip fracture patients from England and Wales (2018–2019) resident in their own home pre-admission were analysed to identify patient and service factors associated with returning home after hospital discharge, and with living in their own home at 120 days. Geographical variation was also analysed. Results analysis of returning home at discharge included 87,797 patients; 57,104 (65%) were discharged home. Patient factors associated with lower likelihood of discharge home included cognitive impairment (odds ratio (OR) 0.60 [95% CI: 0.57, 0.62]), malnutrition (OR 0.81 [0.76, 0.86]), being at risk of malnutrition (OR 0.81 [0.78, 0.85]) and experiencing delay to surgery due to reversal of anti-coagulant medication (OR 0.84 [0.77, 0.92]). Corresponding service factors included surgery delay due to hospital logistical reasons (OR 0.91 [0.87, 0.95]) and early morning admission between 4:00 and 7:59 am (OR 0.83 [0.78, 0.89]). Nerve block prior to arrival at the operating theatre was associated with higher likelihood of discharge home (OR 1.07 [1.03, 1.11]). Most of these associations were stronger when analysing the outcome ‘living in their own home at 120 days’, in which two out of 11 geographic regions were found to have significantly more patients returning home. Conclusion we identify numerous modifiable factors associated with short-term and medium-term return to own home after hip fracture, in addition to significant geographical variation. These findings should support improvements to care and inform future research.

中文翻译：

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髋部骨折后回家的预测因素：一项使用英国国家髋部骨折数据库 (NHFD) 的前瞻性队列研究

简介 我们的目标是描述因髋部骨折住院后回家的趋势，并确定这一以患者为中心的重要结果的预测因素。方法 对来自英格兰和威尔士的一组髋部骨折患者 (2018-2019) 进行分析，这些患者在入院前住在自己的家中，以确定与出院后回家以及 120 天后在自己家中居住相关的患者和服务因素. 还分析了地理差异。出院回家的结果分析包括87,797名患者；57,104 (65%) 人出院回家。与较低出院可能性相关的患者因素包括认知障碍（比值比 (OR) 0.60 [95% CI: 0.57, 0.62]）、营养不良（OR 0.81 [0.76, 0.86]）、处于营养不良风险中（OR 0.81 [95% CI: 0.57, 0.62]） 0.78，0。85]) 并因抗凝药物的逆转而延迟手术 (OR 0.84 [0.77, 0.92])。相应的服务因素包括因医院后勤原因造成的手术延迟 (OR 0.91 [0.87, 0.95]) 和凌晨 4:00 至 7:59 之间的清晨入院 (OR 0.83 [0.78, 0.89])。到达手术室前的神经阻滞与出院回家的可能性较高相关 (OR 1.07 [1.03, 1.11])。在分析“在自己家中居住 120 天”的结果时，这些关联中的大多数都更强，其中发现 11 个地理区域中有两个区域有明显更多的患者返回家园。结论 除了显着的地理差异外，我们还确定了与髋部骨折后短期和中期返回自己家相关的许多可改变因素。