Alliance for the development of the Argentinian Hip Fracture Registry

Abstract

Summary Age expectancy has significantly increased over the last 50 years, as well as some age-related health conditions such as hip fractures. The development of hip fracture registries has shown enhanced patient outcomes through quality improvement strategies. The development of the Argentinian Hip Fracture Registry is going in the same direction. Introduction Age expectancy has increased worldwide in the last 50 years, with the population over 64 growing from 4.9 to 9.1%. As fractures are an important problem in this age group, specific approaches such as hip fracture registries (HFR) are needed. Our aim is to communicate the Argentinian HFR (AHFR) development resulting from an alliance between Fundación Trauma, Fundación Navarro Viola, and the Argentinian Network of Hip Fracture in the elderly. Methods Between October 2020 and May 2021, an iterative consensus process involving 5 specialty-focused meetings and 8 general meetings with more than 20 specialists was conducted. This process comprised inclusion criteria definitions, dataset proposals, website deployment with data protection and user validation, the definition of hospital-adjusted registry levels, implementation planning, and sustainability strategies. Results By June 2021, we were able to (1) outline data fields, including epidemiological, clinical, and functional dimensions for the pre-admission, hospitalization, discharge, and follow-up stages; (2) define three levels: basic (53 fields), intermediate (85), and advanced (99); (3) identify 21 benchmarking indicators; and (4) make a correlation scheme among fracture classifications. Simultaneously, we launched a fundraising campaign to implement the AHFR in 30 centers, having completed 18. Conclusion AHFR development was based on four pillars: (1) representativeness and support, (2) solid definitions from onset, (3) committed teams, and (4) stable funding. This tool may contribute to the design of evidence-based health policies to improve patient outcomes, and we hope this experience will help other LMICs to develop their own tailored-to-their-needs registries.

Standardization of global hip fracture audit could facilitate learning, improve quality, and guide evidence-based practice

“…These were considered in three discrete groups based on origin and duration since becoming established: 1) firstgeneration registries (the longest established programmes that originated from Scandinavia, including: Denmark; Norway; and Sweden); 2) second-generation registries (whose structure was based on the first-generation experience, including: Australia and New Zealand; England, Wales, and Northern Ireland; Germany; Ireland; Netherlands; Scotland; and Spain), and 3) third-generation registries (that have been recently established, are in an introductory period, or have not yet reached nationwide coverage, including: Argentina; China; Japan; Mexico; Pakistan; the Philippines; and South Korea). 9,[18][19][20][21][22][23][24][25][26][27][28] Benchmark dataset. The FFN 2022 MCD includes unit and patient identifiers and 20 core fields that are used to capture demographic details, injury and clinical assessment data, surgical and inpatient management factors, and outcome measures (Supplementary Figure a).…”