{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:49:12Z","timestamp":1777657752825,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Geriatr Orthop Surg Rehabil"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study\u2019s purpose was to use a postoperative ICU geriatric prediction score (PIGS) to determine the appropriateness of postoperative ICU\/SDU admission or unnecessary use of advanced care services in geriatric femur fracture patients at our Level III trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective review of 142 patients, age 65\u00a0years or older, at a level III trauma center from 3\/2021-9\/2022 that required surgical fixation of a femur fracture. Collected data included demographics, injury characteristics, postoperative complications, hospital charges, and admission to ICU or SDU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Average age was 81.5\u00a0years. 32% of patients were male and 40% were femoral neck fractures. The average PIGS score was 7.1. 17% of patients admitted to the SDU met the PIGS threshold for ICU transfer. 7% were transferred to the ICU after being admitted to the SDU postoperatively, 0% of whom met criteria for ICU admission at the level 1 trauma center. Predictive factors for their transfer to the ICU at the level 3 trauma center was postoperative blood transfusion (OR:4.11;CI 1.09,15.45;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.036) and history of cancer or organ transplant (OR:5.86;CI 1.2926.58;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.022). Predictive factor of postoperative death (aside from transfer to ICU) was a history of cancer or organ transplant (OR:13.90;CI 7.65,25.25;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.007). Average gross charges per patient admitted to the floor and the SDU were $80,383 and $82,590, respectively,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.372.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The geriatric population with a femur fracture is often unnecessarily admitted to advanced care units postoperatively. The PIGS system has been validated for use in a level 1 trauma center in the geriatric population undergoing hip fracture surgery. Here, we validate its use in the geriatric population undergoing femur fracture surgery at a level III trauma center, where majority of patients may not meet the criteria for advanced care and could be cared for more cost-effectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21514593251368088","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T22:41:06Z","timestamp":1755211266000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Scoring Methods for Postoperative Level of Care Needs in the Geriatric Hip Fracture Patient Population"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0438-0875","authenticated-orcid":false,"given":"Sarah","family":"Kurkowski","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5155-5167","authenticated-orcid":false,"given":"Jacob","family":"Meyer","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quinn","family":"Retzloff","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Harley","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Claude","family":"Sagi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Laughlin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244291"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.04.015"},{"key":"e_1_3_6_4_2","volume-title":"Healthcare Cost and Utilization Project (HCUP) [database Online]","year":"2012","unstructured":"Healthcare Cost and Utilization Project (HCUP) [database Online]. 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