Endocrine Abstracts

Aim: To compare inpatient length of stay (LOS) and mortality of diabetic and non-diabetic patients aged ≧65 years admitted in a single UK hospital with fractured proximal femur.

Methods: Patients with a fractured proximal femur at University Hospital of Birmingham (2007–2010) were identified from administrative data with ICD 10 discharge diagnostic codes S720, S721 and S722 as the primary diagnosis. A discharge diagnostic code for diabetes or a prescription for diabetes medication (excluding prescription for other clinical needs) was defined as diabetes. Univariate analysis (Mann-Whitney-U-test (LOS) and Chi2 (mortality)) and multivariate analysis (linear regression for LOS after log transformation and logistic regression for mortality) to adjust for age, gender, ethnicity, social class and Charlson co-morbidity score (excluding diabetes) were conducted to contrast and assess the impact of diabetes on fracture of proximal femur in elderly patients.

Results: Among 1468 admissions with fracture of proximal femur 197 had diabetes (13.4%). Diabetes patients had a higher median length of stay but this was not significant (20.2 vs 19.1 days; P=0.17). After adjustment for covariates diabetes patients had a significant impact on length of stay (regression coefficient β of log transformed data=0.062; P=0.05). Inpatient mortality rates were higher in the diabetes patients (14.2 vs.12%) but it was not significant before (P=0.37) or after adjustment for covariates (Odds Ratio 1.11; 0.70–1.77). Increasing age and higher co-morbidity score were independently associated with increasing LOS and mortality (P<0.001).

Conclusion: Diabetes patients tend to have slightly longer length of stay compared to non diabetic patients presenting with fracture of proximal femur. Involvement of diabetes specialist team may have had a favourable outcome in reducing the length of stay and improving quality of care. Further study to understand the impact of diabetes on long term mortality (1 year) will be beneficial.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.