A healthy decline in age- and sex- specific incidence of hip fractures in the elderly in the Republic of Ireland

Coveney, Eamonn I; McKeown, Declan; Quinlan, John; Cleary, May

doi:10.1016/j.surge.2019.11.006

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…The 2016 Census of Ireland highlights this rapid rise with an increase of 19.1% since 2011 [5]. This trend can be seen globally, with the population aged over 65 expected to double by 2060 [6,7]. This aging population will, in turn, increase the projected incidence of hip fractures (Verma et al 2010).…”

Section: Introductionmentioning

confidence: 99%

What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review

Maher

Moore

Avşar³

et al. 2021

Arch Orthop Trauma Surg

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Introduction In orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes. Aim To examine the impact of a fast-track pathway on length of stay for adults admitted to an acute hospital with a hip fracture. Methods CINAHL Plus with Full text (via EBSCO host), MEDLINE, Cochrane Library, and Embase database searches were carried out in January 2021, to find all relevant literature for this review, as well as through searching additional sources. Eligible studies were quantitative primary research, focusing on the use of fast-track admission pathway care versus usual care, for adults with a hip fracture. The assessment of study suitability, data extraction, and critical appraisal was carried out by two independent authors. A narrative analysis of the data was conducted, and data were meta-analysed using RevMan where possible. Quality appraisal of the included studies was undertaken using the EBL checklist. Results Seven studies reporting data on 5723 patients were included. Length of stay, time to surgery, and mortality did not differ significantly between the fast-track care, and usual care. One study reported on delirium and found statistically significantly fewer encounters of delirium in fast-track care versus usual care. Four of the seven studies satisfied rigorous quality appraisal (> 75%) using the EBL. ConclusionThe fast-track pathway avoided unnecessary delays in emergency departments due to faster X-rays, direct admission to orthopaedic wards, and reduced delirium rates. However, results were unable to show the impact of fast-track on length of stay, time to surgery, and mortality.

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Section: Introductionmentioning

confidence: 99%

What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review

Maher

Moore

Avşar³

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

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“…ip fractures in the elderly are associated with substantial patient morbidity and mortality as well as socioeconomic burden for the health system [1][2][3] . While the incidence of proximal femoral fractures has decreased in the past decade 4,5 , the incidence of acetabular fragility fractures is increasing [6][7][8] .…”

mentioning

confidence: 99%

Lower 1-Year Postoperative Mortality After Acetabular Versus Proximal Femoral Fractures in Elderly Patients

Stetzelberger

Brouze

Steppacher

et al. 2021

Journal of Bone and Joint Surgery

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Background:Geriatric acetabular fractures are becoming more common due to demographic changes. Compared with proximal femoral fractures, surgical treatment is more complex and often does not allow full-weight-bearing. The aims of this study were to compare operatively treated acetabular and proximal femoral fractures with regard to (1) cumulative 1-year mortality, (2) perioperative complications, and (3) predictive factors associated with a higher 1-year mortality.Methods:This institutional review board-approved comparative study included 486 consecutive surgically treated elderly patients (136 acetabular and 350 proximal femoral fractures). After matching, 2 comparable groups of 129 acetabular and 129 proximal femoral fractures were analyzed. Cumulative 1-year mortality was evaluated through Kaplan-Meier survivorship analysis, and perioperative complications were documented and graded. After confirming that the proportionality assumption was met, Cox proportional hazard modeling was conducted to identify factors associated with increased 1-year mortality.Results:The acetabular fracture group had a significantly lower cumulative 1-year mortality before matching (18% compared with 33% for proximal femoral fractures, log-rank p = 0.001) and after matching (18% compared with 36%, log-rank p = 0.005). Nevertheless, it had a significantly higher overall perioperative complication rate (68% compared with 48%, p < 0.001). In our multivariable Cox regression analysis, older age, perioperative blood loss of >1 L, and wheelchair mobilization were associated with lower survival rates after acetabular fracture surgery. Older age and a higher 5-item modified frailty index were associated with a higher 1-year mortality rate after proximal femoral fractures, whereas postoperative full weight-bearing was protective.Conclusions:Despite the complexity of operative treatment and a higher complication rate after acetabular fractures in the elderly, the 1-year mortality rate is lower than that after operative treatment of proximal femoral fractures, even after adjustment for comorbidities.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Peri-implant femoral fractures in hip fracture patients treated with osteosynthesis: a retrospective cohort study of 1965 patients

Kruse

Mohammed

Sayed-Noor

et al. 2021

Eur J Trauma Emerg Surg

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A healthy decline in age- and sex- specific incidence of hip fractures in the elderly in the Republic of Ireland

Cited by 5 publications

References 18 publications

What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review

What is the impact of a fast-track pathway on length of stay for adult patients with a hip fracture? A systematic review

Lower 1-Year Postoperative Mortality After Acetabular Versus Proximal Femoral Fractures in Elderly Patients

Peri-implant femoral fractures in hip fracture patients treated with osteosynthesis: a retrospective cohort study of 1965 patients

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