[Functional and clinical outcomes in patients admitted to nursing homes after hip fractures. Implementation of a multi-level intervention program]

[Functional recovery units state in orthogeriatrics according to data from the National Registry of Hip Fracture]

INTRODUCTION

The National Registry of Hip Fractures (RNFC) facilitates knowledge of hip fracture process in Spain to clinicians and managers and is useful to the reduction of the results variability, including the destination at discharge after the hip fracture.

OBJECTIVE

The aim of this study was to describe functional recovery units (URFs) use for patients with hip fracture included in the RNFC and to compare the results of the different autonomous communities (AC).

MATERIAL AND METHODS

An observational, prospective and multicenter study of several hospitals in Spain. Data from a RNFC cohort of patients admitted with hip fracture between 2017 and 2022 were analyzed, focusing on the location at discharge of the patients, specifically on transfer to the URF.

RESULTS

52,215 patients from 105 hospitals were analyzed, 9540 patients (18.1%) were transferred to URF upon discharge and 4595 (8.8%) remained in these units 30 days later, with a variable distribution between the different AC (0-49%) and variability of results in patients not recovering ambulation at 30 days (12.2-41.9%).

CONCLUSIONS

There is in orthogeriatric patient an unequal availability and use of URFs between different autonomous communities. The study of the usefulness of this resource can be of great value for decision-making in health policies.

[Health consequences (mortality and institutionalization) of hip fracture among the elderly people: Population cohort study in Segovia]

OBJECTIVE

In order to know the social and health consequences of hip fractures (HF).

DESIGN

A retrospective cohort study of an entire health area was carried out in patients aged 75 or more, over a period of 5 years. SITE: Segovia Health Area.

PARTICIPANTS

All patients older than 75 years with a diagnosis of HF, excluding displaced and passerby.

INTERVENTIONS

The socio-sanitary changes that occur after the HF in respect to their baseline situation (family situation, comorbidities, dependence and mental situation) and the variables which most influence mortality and institutionalization after the HF were analyzed.

MAIN MEASUREMENTS

One thousand one hundred fifty-nine HF were recorded, with a constant annual incidence of 10.7‰. The prevalence was higher in women: 7.4% versus 3.7%.

RESULTS

The baseline profile is a pluripatological, non-institutionalized, 87-year-old woman, who retains her independent in her daily life and suffers from a HF due to an accidental fall in her home. At the end of the study period 51% were permanently institutionalized, negatively influencing having worse mental deterioration, worse dependence and subsequent readmissions and in addition, 45.5% died, 25.5% during the first year. The most unfavorable conditions were being previously dependent, having severe mental deterioration, male and within the comorbidities the most influential was previously having an anemia.

CONCLUSIONS

Our data confirms the deterioration of the autonomy-functional capacity after a HF, in line with what has been published, and has allowed to identify which elderly people are at the greatest risk of complications in the short and medium term (institutionalization and death).