Abstract
Background/Objectives: Hip fractures in older patients frequently lead to early readmissions, which negatively impact patient outcomes and significantly increase healthcare costs. Identifying and understanding risk factors for 30-day readmission following hip fracture surgery is essential for improving patient management and optimizing healthcare resource utilization. Methods: A systematic literature search was conducted using PubMed, EMBASE, and the Cochrane Library databases up to 30 December 2024. Studies investigating potential risk factors for 30-day readmission following hip fracture surgery were included. The risk factors were meta-analytically pooled, and odds ratios (ORs) were calculated using a random-effects model. Results: Twelve studies comprising 128,053 patients were included. Pooled analyses revealed significant associations between higher readmission rates and factors such as male sex (OR = 1.45; 95% CI, 1.27-1.65), hip arthroplasty surgery (OR = 1.36; 95% CI, 1.03-1.80), advanced age (OR, 1.22; 95% CI 1.00-1.49), high American Society of Anesthesiologists (ASA) Physical Status Classification System class (OR, 2.22; 95% CI, 1.28-3.85), and high Charlson comorbidity index (OR, 1.67; 95% CI, 1.36-2.05). Additionally, the most frequently reported comorbidities associated with higher readmission risks were diabetes mellitus and congestive heart failure, with ORs of 1.63 and 1.57, respectively. Conclusions: Male sex, advanced age, higher ASA scores, and greater preoperative comorbidity burdens significantly increase the risk of 30-day readmission following hip fracture surgery. Effective risk stratification and targeted perioperative management strategies addressing these identified factors may reduce early readmission rates and enhance postoperative patient outcomes.