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Changing trends in hip fracture epidemiology in the Republic of Ireland: a follow-up study. Arch Osteoporos 2022; 17:79. [PMID: 35575820 DOI: 10.1007/s11657-022-01112-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/25/2022] [Indexed: 02/03/2023]
Abstract
A national, population-based study of hip fracture epidemiology is reported following a previously published study for the same population to ascertain the accuracy of projected incidence rates. Results suggest a decline in age-specific incidence rates in females but not males, and an over-estimation of same in the previously reported projections. PURPOSE Accurate estimates of hip fracture numbers and incidence rates are necessary for health service resource planning. A study in 2009 estimated projected figures for 2016 and 2026, for the Republic of Ireland. The purpose of the current study was to scrutinize these projections, based upon actual population and fracture statistics for the year 2016. METHODS Population data was obtained from the Central Statistics Office, and hip fracture data was obtained from the National HIPE Database for the year 2016, using similar search criteria to the previously published study. Hip fracture numbers and incidence rates were calculated. The calculated figures were compared to projected figures from the previous report. RESULTS Population projection models used in the 2009 paper accurately reflected the 2016 Irish population. For younger age groups, projected number of fractures closely estimated actual numbers, however, for those over 70 years of age, hip fracture projections overestimated the actual fracture numbers observed. There was a significant difference in the age-specific hip fracture rates in the over 70 s sub-groups compared to the published results of the 2009 study. CONCLUSIONS Hip fracture numbers continue to increase, though the age-specific incidence rates in the Republic of Ireland are reducing in the older age groups. The previously published study over-estimated hip fracture projections for the year 2016 (and potentially 2026) due to a false assumption of a stable age-specific incidence rate in the Republic of Ireland, which is in fact reducing.
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Schoeneberg C, Pass B, Volland R, Knobe M, Eschbach D, Ketter V, Lendemans S, Aigner R. Four-month outcome after proximal femur fractures and influence of early geriatric rehabilitation: data from the German Centres of Geriatric Trauma DGU. Arch Osteoporos 2021; 16:68. [PMID: 33846869 DOI: 10.1007/s11657-021-00930-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/16/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study analyzed the outcome of orthogeriatric patients with hip fracture 4 months after surgery. The overall mortality rate was 12.2%. Sixty-five percent presented a degradation in walking ability, and 16% had to move to a nursing home. Early geriatric rehabilitation reduces the mortality rate and increases the rate of anti-osteoporotic treatment. PURPOSE Hip fractures are increasingly common with severe consequences. Therefore, the German Trauma Society (DGU) implemented an orthogeriatric co-management and developed the concept for certified Centre for Geriatric Trauma DGU. The patients' treatment data and the optional 120 days of follow-up were collected in the Registry for Geriatric Trauma DGU (ATR-DGU). This study analyzed these 4-month treatment results. METHODS A retrospective analysis of the ATR-DGU was conducted. Outcome parameters were the rate of readmission, rate of re-surgery, anti-osteoporotic therapy, housing, mortality, walking ability, and quality of life (QoL) 120 days post-surgery. The influence of the early geriatric rehabilitation (EGR) was evaluated using a regression analysis. RESULTS The follow-up data from 9780 patients were included. After 120 days, the mortality rate was 12.2%, the readmission rate 4%, and the re-surgery rate 3%. The anti-osteoporotic treatment increased from 20% at admission to 32%; 65% of the patients had a degradation in walking ability, and 16% of the patients who lived in their domestic environment pre-surgery had to move to a nursing home. QoL was distinctly reduced. The EGR showed a positive influence of anti-osteoporotic treatment (p<0.001) and mortality (p=0.011) but led to a slight reduction in QoL (p=0.026). CONCLUSION The 4-month treatment results of the ATR-DGU are comparable to international studies. The EGR led to a significant rise in anti-osteoporotic treatment and a reduction in mortality with a slight reduction in QoL.
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Affiliation(s)
- Carsten Schoeneberg
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
| | - Bastian Pass
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany
| | - Ruth Volland
- AUC, Academy for Trauma Surgery GmbH, Munich, Germany
| | - Matthias Knobe
- Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Daphne Eschbach
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Vanessa Ketter
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
| | - Sven Lendemans
- Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany
| | - Rene Aigner
- Center for Orthopedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany
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Walsh ME, Ferris H, Coughlan T, Hurson C, Ahern E, Sorensen J, Brent L. Trends in hip fracture care in the Republic of Ireland from 2013 to 2018: results from the Irish Hip Fracture Database. Osteoporos Int 2021; 32:727-736. [PMID: 32997154 DOI: 10.1007/s00198-020-05636-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023]
Abstract
UNLABELLED Hip fractures continue to be one of the most serious and costly injuries suffered by older people globally. This paper describes the development of a national hip fracture audit and summarises the first 6 years of data from the Republic of Ireland. This can help inform care, standards and outcomes of hip fracture patients. INTRODUCTION Ireland has one of the highest standardised rates of hip fracture in the world behind northern European countries. The Irish Hip Fracture Database (IHFD) was established in 2012 to drive clinical and organisational improvements in quality and effectiveness of hip fracture care. This paper describes the progression of the IHFD between 2013 and 2018 and identifies trends and areas for improvement. METHODS The IHFD is a clinically led, web-based audit, with data collected through the national Hospital Inpatient Enquiry (HIPE) electronic system, the principal source of information from publicly funded acute hospitals in Ireland. Eligible cases are aged ≥ 60 years with hip fracture as defined by IHFD or with other specified hip fracture excluding periprosthetic fractures. As of 2015, all 16 trauma-receiving hospitals within Ireland submitted data. Demographics and adherence to six national quality standards are described. RESULTS A total of 17,983 cases were included in the analysis. National coverage has increased from 63% in 2013 to 99% in 2018. Demographic characteristics are unchanged, but higher levels of comorbidity are seen. Internal fixation and hemiarthroplasty are the most common modes of surgical repair with two-thirds of cases receiving spinal rather than general anaesthesia. Increasingly patients are being assessed by a geriatrician (11% in 2013 to 69% in 2018) and receive a bone health assessment (65% in 2013 to 84% in 2018). CONCLUSION While some hip fracture standards have improved, further improvements are required to compare favourably internationally. Reduction of surgical delay and ensuring early mobilisation post-operatively are immediate priorities for the IHFD.
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Affiliation(s)
- M E Walsh
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - H Ferris
- Department of Public Health, HSE South, St. Finbarr's Hospital, Cork, Ireland
- Strategic Planning and Transformation, Department of Public Health, Mount Kennett House, Henry St, Limerick, Ireland
| | - T Coughlan
- Department of Medicine, Tallaght University Hospital, Tallaght, Dublin 24, D24 NR0A, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Dublin 2, Ireland
| | - C Hurson
- Department of Trauma and Orthopaedics, St Vincent's University Hospital, Dublin, Dublin 4, Ireland
| | - E Ahern
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
| | - J Sorensen
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - L Brent
- National Office of Clinical Audit, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Goh EL, Lerner RG, Achten J, Parsons N, Griffin XL, Costa PML. Complications following hip fracture: Results from the World Hip Trauma Evaluation cohort study. Injury 2020; 51:1331-1336. [PMID: 32268962 PMCID: PMC7322551 DOI: 10.1016/j.injury.2020.03.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Hip fractures are common in people over 60 years of age, and are associated with significant disability, morbidity and mortality. The aim of this study was to record the incidence of complications in the first 120 days following hip fracture. METHODS The World Hip Trauma Evaluation (WHiTE) study is a multicentre, prospective cohort study conducted in National Health Service (NHS) hospitals in England and Wales. Participants are 60 years and older who received operative treatment for a hip fracture. We report the incidence of complications recorded by hospital staff until discharge from hospital and by participants at 120-days post-surgery. RESULTS An analysis of 8673 consecutive participants enrolled in the WHiTE study revealed the following risks of complications within the first 120 days: signs of wound infection (3.1%); dislocation (0.5%); failure of fixation (0.6%); peri‑prosthetic fracture (0.3%); overall revision surgery (0.9%); blood loss requiring transfusion (6.1%); chest infection (6.3%); urinary tract infection (5.0%); deep vein thrombosis/pulmonary embolus (1.8%); cerebrovascular accident (0.6%); acute coronary syndrome/myocardial infarction (0.6%); acute kidney injury (1.3%). CONCLUSION The rates of complications reported here provide a reference range against which future studies might be assessed. Registration: ISRCTN63982700.
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Affiliation(s)
- En Lin Goh
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, OX3 9DU, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Trauma Research, Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Robin G Lerner
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Juul Achten
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Nick Parsons
- Statistics and Epidemiology Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7 AL, United Kingdom
| | - Xavier L Griffin
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, OX3 9DU, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Trauma Research, Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Professor Matthew L Costa
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, OX3 9DU, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Trauma Research, Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
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Molina Hernández MJ, González de Villaumbrosia C, Martín de Francisco de Murga E, Alarcón Alarcón T, Montero-Fernández N, Illán J, Bielza R, Mora-Fernández J. [Multi-centre register study of hip fractures in Orthogeriatric Units in the Community of Madrid (Spain)]. Rev Esp Geriatr Gerontol 2018; 54:5-11. [PMID: 30131189 DOI: 10.1016/j.regg.2018.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/12/2018] [Accepted: 07/25/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To describe the characteristics of patients with hip fractures admitted over a period of two years (from January 2015 to December 2016) in eight Orthogeriatric Units in public hospitals of the Community of Madrid. MATERIAL AND METHOD This is a descriptive, prospective and multi-centre study. In 2014, all hospitals in Madrid providing joint Geriatric and Traumatology assistance were invited to a recently created orthogeriatric work group. Geriatricians in charge of the Orthogeriatric Unit from eight hospitals took part in this study. The participants established a database including all variables that influenced health outcomes (socio-demographic and clinical variables). RESULTS The study includes 3,995 patients, with a mean age of 85.3years (range: 58-108years old). Two-thirds of them were ASA (American Society Physical Status Classification System) III-IV. Almost all (96.7%) of the patients underwent a surgical operation, and 35.9% of them were operated during the first 48hours. The delay was mainly due to logistic problems (43.5%). The mean hospital stay was 11.2days. Just over half (53.1%) of the patients required a blood transfusion. In-hospital mortality was 5.3%. DISCUSSION Hip fracture registries are essential tools to monitor the healthcare process of these patients, as well as to improve the quality of care. Our results are similar to other records. It would be necessary to improve pre-operative time, which must be less than 48hours in patients without clinical instability. We also need more resources for functional recovery and more uniformity.
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Affiliation(s)
| | | | | | | | - Nuria Montero-Fernández
- Servicio de Geriatría, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Julia Illán
- Hospital Universitario de Getafe, Getafe, Madrid, España
| | - Rafael Bielza
- Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Jesús Mora-Fernández
- Servicio de Geriatría, IdISSC, Hospital Universitario Clínico San Carlos, Madrid, España.
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Wilk R, Skrzypek M, Kowalska M, Kusz D, Koczy B, Zagórski P, Pluskiewicz W. The 13-year observation of hip fracture in Poland-worrying trend and prognosis for the future. Aging Clin Exp Res 2018; 30:61-69. [PMID: 28353218 PMCID: PMC5785595 DOI: 10.1007/s40520-017-0747-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/10/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Hip fractures are often considered to be one of the most common osteoporotic fractures. In our previous study, we noted the increasing trend in the total number of hip fractures as well as crude and standardized rates, for both women and men. This observation enabled us to delve deeper into the study of osteoporotic fractures. METHODS Hospital records between 1.01.2002 and 31.12.2014 with ICD-10 codes S72.0. S72.1 and S72.2 (femoral neck. intertrochanteric, subtrochanteric, and inter and subtrochanteric fracture) were analysed. All fractures occurred in citizens who lived in the district Tarnowskie Góry and the city of Piekary Śląskie aged 50 years and more. RESULTS 1507 fragility hip fractures (400 in men, and 1107 in women) were registered. The rates increase in both sexes was still observed. The tendency to sustain fractures was lower in female (29.3%) than in the male population (63.6%). We observed a lower increase in urban (35.8%) population when compared to rural (40.8%) population. Incidence rate ratios for female gender were 1.89 (95% CI 1.65-2.18). The rates in 2014 were as follows: crude rate of 216.2 (men 140.9; women 276.5) and standardized 183.9 (131.6 and 219.4, respectively). This observation allowed as to project a total crude rate of 467.2 (men 329.6; women 584.7) for the year 2050. CONCLUSIONS The number of osteoporotic hip fractures in Polish men and women is still relatively low, but the epidemiological situation is getting worse. The over 13 years of follow-up demonstrated that the trend to increase in total number of hip fractures for men and women is still observed. This prognosis is of a major concern.
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Prieto-Alhambra D, Reyes C, Sainz MS, González-Macías J, Delgado LG, Bouzón CA, Gañan SM, Miedes DM, Vaquero-Cervino E, Bardaji MFB, Herrando LE, Baztán FB, Ferrer BL, Perez-Coto I, Bueno GA, Mora-Fernandez J, Doñate TE, Blasco JMI, Aguado-Maestro I, Sáez-López P, Doménech MS, Climent-Peris V, Rodríguez ÁD, Sardiñas HK, Gómez ÓT, Serra JT, Caeiro-Rey JR, Cano IA, Carsi MB, Etxebarria-Foronda I, Hernández JDA, Solis JR, Suau OT, Nogués X, Herrera A, Díez-Perez A. In-hospital care, complications, and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study. Arch Osteoporos 2018; 13:96. [PMID: 30218380 PMCID: PMC6153683 DOI: 10.1007/s11657-018-0515-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/31/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED We have characterised 997 hip fracture patients from a representative 45 Spanish hospitals, and followed them up prospectively for up to 4 months. Despite suboptimal surgical delays (average 59.1 hours), in-hospital mortality was lower than in Northern European cohorts. The secondary fracture prevention gap is unacceptably high at 85%. PURPOSE To characterise inpatient care, complications, and 4-month mortality following a hip or proximal femur fracture in Spain. METHODS Design: prospective cohort study. Consecutive sample of patients ≥ 50 years old admitted in a representative 45 hospitals for a hip or proximal femur fragility fracture, from June 2014 to June 2016 and followed up for 4 months post-fracture. Patient characteristics, site of fracture, in-patient care (including secondary fracture prevention) and complications, and 4-month mortality are described. RESULTS A total of 997 subjects (765 women) of mean (standard deviation) age 83.6 (8.4) years were included. Previous history of fracture/s (36.9%) and falls (43%) were common, and 10-year FRAX-estimated major and hip fracture risks were 15.2% (9.0%) and 8.5% (7.6%) respectively. Inter-trochanteric (44.6%) and displaced intra-capsular (28.0%) were the most common fracture sites, and fixation with short intramedullary nail (38.6%) with spinal anaesthesia (75.5%) the most common procedures. Surgery and rehabilitation were initiated within a mean 59.1 (56.7) and 61.9 (55.1) hours respectively, and average length of stay was 11.5 (9.3) days. Antithrombotic and antibiotic prophylaxis were given to 99.8% and 98.2% respectively, whilst only 12.4% received secondary fracture prevention at discharge. Common complications included delirium (36.1 %) and kidney failure (14.1%), with in-hospital and 4-month mortality of 2.1% and 11% respectively. CONCLUSIONS Despite suboptimal surgical delay, post-hip fracture mortality is low in Spanish hospitals. The secondary fracture prevention gap is unacceptably high at > 85%, in spite of virtually universal anti-thrombotic and antibiotic prophylaxis.
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Affiliation(s)
- Daniel Prieto-Alhambra
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l’Aparell Locomotor) Research Group, CIBERFES, IDIAP Jordi Gol (Universitat Autònoma de Barcelona) and Instituto de Salud Carlos III, Av Gran Via de les Corts Catalanes, 587, Atic, 08007 Barcelona, Spain ,Musculoskeletal Pharmaco and Device Epidemiology – Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD UK ,Musculoskeletal Research Unit, IMIM-Parc Salut Mar, CIBERFES, Universitat Autònoma de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Carlen Reyes
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l’Aparell Locomotor) Research Group, CIBERFES, IDIAP Jordi Gol (Universitat Autònoma de Barcelona) and Instituto de Salud Carlos III, Av Gran Via de les Corts Catalanes, 587, Atic, 08007 Barcelona, Spain
| | - Miguel Sanz Sainz
- IIS Aragón (Instituto de Investigación Sanitaria de Aragón), Hospital Universitario Miguel Servet, Padre Arrupe, s/n, 50009 Zaragoza, Spain
| | - Jesús González-Macías
- IDIVAL (Instituto de Investigación Marqués de Valdecilla), HUMV (Hospital Universitario Marqués de Valdecilla), UC (Universidad de Cantabria), Av de Valdecilla sn, 39011 Santander, Cantabria Spain
| | - Luis Gracia Delgado
- Hospital Universitario Reina Sofía de Cordoba, Av Menendez Pidal, 14004 Córdoba, Spain
| | - Cristina Alonso Bouzón
- Geriatric Unit, Hospital Universitario de Getafe, Carr. De Madrid – Toledo, Km 12,500, 28905 Getafe, Madrid Spain
| | - Sarah Mills Gañan
- Traumatology and Orthopaedics Unit, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | | | | | | | - Laura Ezquerra Herrando
- F.E.A of the Traumatology and Orthopaedics Unit, Hospital Clínico Universitario Lozano Blesa, Av. San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - Fátima Brañas Baztán
- Geriatric Unit, Hospital Universitario Infanta Leonor, Gran Vía del Este, 80, 28031 Madrid, Spain
| | - Bartolomé Lladó Ferrer
- Hospital Son Llàtzer, Carretera de Manacor, PQ 4 (Son Ferriol), 07198 Palma de Mallorca, Spain
| | - Ivan Perez-Coto
- Hospital Universitario San Agustín, Camino de Heros, 6, 33401 Avilés, Asturias Spain
| | - Gaspar Adrados Bueno
- Internal Medicine Unit, Hospital Infanta Cristina, Av. de Elvas, s/n, 06080 Badajoz, Spain
| | - Jesús Mora-Fernandez
- Geriatric Unit, Hospital Clínico San Carlos, calle Prof. Martín Lagos s/n, 28040 Madrid, Spain
| | | | | | | | - Pilar Sáez-López
- Hospital Universitario Fundación Jiménez Díaz, IdiPAZ (Instituto de Investigación del Hospital La Paz), Madrid, Spain
| | - Monica Salomó Doménech
- Corporación sanitaria Universitaria Parc Tauli, Parc Taulí, 1, 08208 Sabadell, Barcelona Spain
| | - Vicente Climent-Peris
- Traumatology and Orthopaedics Unit, Hospital Públic Lluis Alcanyis de Xàtiva, Carretera Xátiva-Silla, Km 2, 46800 Xàtiva, Valencia Spain
| | - Ángel Díez Rodríguez
- Traumatology and Orthopaedics Unit, Hospital Virgen del Puerto, Paraje Valcorchero, 10600 Plasencia, Cáceres Spain
| | - Humberto Kessel Sardiñas
- Geriatric Care Unit, Complejo Hospitalario Torrecárdenas, Calle Hermandad de Donantes de Sangre, 04009 Almería, Spain
| | - Óscar Tendero Gómez
- Hospital Universitari Son Espases, Carr. de Valldemossa, 79, 07120 Palma, Islas Baleares Spain
| | - Jordi Teixidor Serra
- Hospital Universitari Vall de Hebron, Passeig de la Vall d’Hebron, 119-129, 08035 Barcelona, Spain
| | - José Ramón Caeiro-Rey
- Traumatology and Orthopaedics Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña Spain
| | | | - Mariano Barrés Carsi
- Hospital Universitari i Politècnic La Fe, Av de Fernando Abril Martorell, 106, 46026 València, Spain
| | | | - Juan Dionisio Avilés Hernández
- Orthogeriatric Unit, Hospital Clínico Universitario Virgen de Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia Spain
| | - Juan Rodriguez Solis
- Geriatric Unit, Hospital Universitario de Guadalajara, Calle Donante de Sangre, s/n, 19002 Guadalajara, Spain
| | - Oscar Torregrosa Suau
- Bone Metabolism Unit, Internal Medicine Unit, Hospital General Universitari d’Elx, Carrer Almazara, 11, 03203 Elche, Alicante Spain
| | - Xavier Nogués
- Internal Medicine Department IMIM (Hospital del Mar Medical Research), CIBER FES ISCIII, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Antonio Herrera
- Department of Surgery, Aragón Health Research Institute, University of Zaragoza, Zaragoza, Spain
| | - Adolfo Díez-Perez
- Musculoskeletal Research Unit, IMIM-Parc Salut Mar, CIBERFES, Universitat Autònoma de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain
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Muñoz-Pascual A, Sáez-López P, Jiménez-Mola S, Sánchez-Hernández N, Alonso-García N, Andrés-Sainz AI, Macias-Montero MC, Vázquez-Pedrezuela C, Pereira de Castro Juez N, Del Pozo-Tagarro P, Pablos-Hernández C, Cervera-Díaz C, Cerón-Fernández A, Vuelta-Calzada E, Perez-Jara Carrera J, González-Ramírez A, Collado-Díaz T, Idoate-Gil J, Guerrero-Díaz MT, Gutierrez-Bejarano D, Martín-Perez E. [Orthogeriatrics: The First multicentre regional register of hip fractures in Castilla y León (Spain)]. Rev Esp Geriatr Gerontol 2017; 52:242-248. [PMID: 28522074 DOI: 10.1016/j.regg.2017.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 02/12/2017] [Accepted: 03/13/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective of this study is to describe the characteristics of the patients with hip fracture admitted to the Public Hospitals of Castilla y León during three monthly periods (November 2014, and October and November 2015). MATERIAL AND METHOD The Castilla y León orthogeriatrics work group created a common register to collect data on hip fractures. The study included patients 75 years-old and over hospitalised with hip fractures in the 13 public hospitals in the community during November 2014, and October and November 2015. A multicentre, prospective, and observational study was conducted, in which clinical, functional, and social variables, as well as in-hospital mortality, were collected. RESULTS The analysis included data from a total of 776 patients with a mean age of 86 (±6) years. The surgical delay was 4±2.8 days, and the mean hospital stay was 10±4.7 days. The anaesthesia risk was ASA 3±0.6. Around two-thirds (66.5%) of the patients had medical complications while in hospital, and 55.5% required a transfusion. In-hospital mortality was 4.6%. The mean pre-surgical stay was related to the overall stay: P<.001. CONCLUSIONS Hip fracture registers are an essential tool for evaluating the process and for improving the treatment quality of these patients. This is the first multicentre register of hip fracture in the elderly created in a Spanish region, and could be a good precedent reference for a future national register.
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Affiliation(s)
| | - Pilar Sáez-López
- Unidad de Geriatría, Complejo Asistencial de Ávila, Ávila, España; Instituto de Investigación Hospital Universitario La Paz, Fundación Idi Paz, Ávila, España.
| | - Sonia Jiménez-Mola
- Unidad de Geriatría, Complejo Asistencial Universitario de León, León, España
| | | | | | | | | | | | | | | | | | - Carmen Cervera-Díaz
- Unidad de Geriatría, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | | | | | | | | | | | - Javier Idoate-Gil
- Unidad de Geriatría, Complejo Asistencial Universitario de León, León, España
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Pitzul KB, Munce SEP, Perrier L, Beaupre L, Morin SN, McGlasson R, Jaglal SB. Scoping review of potential quality indicators for hip fracture patient care. BMJ Open 2017; 7:e014769. [PMID: 28325859 PMCID: PMC5372037 DOI: 10.1136/bmjopen-2016-014769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purpose of this study is to identify existing or potential quality of care indicators (ie, current indicators as well as process and outcome measures) in the acute or postacute period, or across the continuum of care for older adults with hip fracture. DESIGN Scoping review. SETTING All care settings. SEARCH STRATEGY English peer-reviewed studies published from January 2000 to January 2016 were included. Literature search strategies were developed, and the search was peer-reviewed. Two reviewers independently piloted all forms, and all articles were screened in duplicate. RESULTS The search yielded 2729 unique articles, of which 302 articles were included (11.1%). When indicators (eg, in-hospital mortality, acute care length of stay) and potential indicators (eg, comorbidities developed in hospital, walking ability) were grouped by the outcome or process construct they were trying to measure, the most common constructs were measures of mortality (outcome), length of stay (process) and time-sensitive measures (process). There was heterogeneity in definitions within constructs between studies. There was also a paucity of indicators and potential indicators in the postacute period. CONCLUSIONS To improve quality of care for patients with hip fracture and create a more efficient healthcare system, mechanisms for the measurement of quality of care across the entire continuum, not just during the acute period, are required. Future research should focus on decreasing the heterogeneity in definitions of quality indicators and the development and implementation of quality indicators for the postacute period.
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Affiliation(s)
- Kristen B Pitzul
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sarah E P Munce
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Laure Perrier
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Beaupre
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Susan B Jaglal
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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McGarvey C, Coughlan T, O'Neill D. Ageism in Studies on the Management of Osteoporosis. J Am Geriatr Soc 2017; 65:1566-1568. [DOI: 10.1111/jgs.14840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/30/2016] [Accepted: 01/03/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Caoimhe McGarvey
- Centre for Ageing, Neuroscience and the Humanities Trinity College Dublin Dublin Ireland
| | - Tara Coughlan
- Centre for Ageing, Neuroscience and the Humanities Trinity College Dublin Dublin Ireland
| | - Desmond O'Neill
- Centre for Ageing, Neuroscience and the Humanities Trinity College Dublin Dublin Ireland
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Krušič D, Brilej D, Currie C, Komadina R. Audit of geriatric hip fracture care - a Slovenian trauma center analysis. Wien Klin Wochenschr 2016; 128:527-534. [PMID: 27896467 DOI: 10.1007/s00508-016-1137-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 11/09/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected. Follow-up after 30 days included hip-related readmission, mobility, residence and life status. RESULTS Included were 495 patients with a mean age of 81 years of which 20% were preoperatively seen by a physician or geriatrician, 93.1% had surgical repair, 58.5% of them within 48 h of admission. The mortality rate in hospital was 5.4% and 10.1% at follow-up, 61.8% patients were able to return to prefracture residency and 23% could walk with minor assistance. CONCLUSION This comprehensive and detailed audit report provides baseline data on case-mix, care and outcomes following hip fractures in Slovenia, in advance of planned quality improvement work in geriatric fracture care and provides a strong basis for the assessment of the impact of the GFC model of care.
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Affiliation(s)
- Dejan Krušič
- Trauma Department, General and Teaching hospital Celje, Oblakova 5, 3000, Celje, Slovenia
| | - Drago Brilej
- Trauma Department, General and Teaching hospital Celje, Oblakova 5, 3000, Celje, Slovenia.
| | - Colin Currie
- Formerly of Geriatric Medicine Unit, School of Clinical Sciences and Community Health, College of Medicine and Veterinary Medicine, Edinburgh University, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Radko Komadina
- Trauma Department, General and Teaching hospital Celje, Oblakova 5, 3000, Celje, Slovenia
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