An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006

Cogan, Lisa; Martin, Alan J.; Kelly, Lisa A.; Duggan, Joseph; Hynes, D. M.; Power, Dermot

doi:10.1007/s11845-009-0377-6

Cited by 26 publications

(25 citation statements)

References 12 publications

(11 reference statements)

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“…Our pa ents' mean age is 83.56 years while, in other studies, the mean age fi gures between 80.17 and 82.3 years (13)(14)(15)(16)(17) , except in one Brazilian study (18) , with a mean age of 77.3 years.…”

Section: Discussioncontrasting

confidence: 56%

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Evaluación funcional en ancianos intervenidos de fractura de cadera

Montalbán-Quesada

García‐García

Moreno-Lorenzo

2012

Rev. esc. enferm. USP

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This prospec ve study was performed in pa ents aged 65 years or older who underwent hip fracture surgery. The objec ve was to determine the func onal evolu on in a group of pa ents three months a er hospital discharge, to iden fy the variables related to this func onal recovery and to describe the associated mortality and instu onaliza on process. We analyzed demographic variables such as age, sex, and living situa on. Other aspects considered included: comorbidity, cogni ve impairment, walking ability, dependency level according to Barthel's Index, ins tu onaliza on, and mortality. The informa on was collected on admission and three months a er discharge. Considering the en re sample, 89.6% was female and the average age was 83.56 years; 40% of pa ents regained their prior independence and a 16.7% mortality rate was registered, together with a slight progression toward ins tu onalizaon. The func onal capacity and cogni ve impairment of pa ents before the fracture are determinants of func onal recovery and subsequent recovery of independence. DESCRIPTORS RESUMENEstudio observacional prospec vo en pacientes mayores de 65 años intervenidos de fractura de cadera. El obje vo fue conocer la evolución funcional de los pacientes a los tres meses del alta hospitalaria, iden fi car variables relacionadas con dicha recuperación funcional, describir la mortalidad e ins tucionalización asociadas al proceso. Se analizaron variables demográfi cas como edad, sexo, convivencia. Otros aspectos registrados fueron: comorbilidad, deterioro cogni vo, capacidad para caminar, nivel de dependencia según índice de Barthel, ins tucionalización y mortalidad. Se recogió la información al ingreso y a los 3 meses del alta. El 89,6% de la muestra, fueron mujeres, la edad media fue de 83,56 años. El 40% de los pacientes recuperaron la independencia previa registrándose una mortalidad del 16,7% así como una leve progresión hacia la ins tucionalización. La capacidad funcional y el deterioro cogni vo del paciente, previos a la fractura condicionan su recuperación funcional y dependencias posteriores.

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Section: Discussioncontrasting

confidence: 56%

“…Also, ins tu onaliza on at one year a er the hip fracture process ranges from 9% to 29% (2,13,(17)(18)(19) . The result obtained in our sample (22.5%) at three months is in agreement with another author who observed no signifi cant changes in the place of residence as from four months after the fracture (20) .…”

Section: Discussionmentioning

confidence: 99%

Evaluación funcional en ancianos intervenidos de fractura de cadera

Montalbán-Quesada

García‐García

Moreno-Lorenzo

2012

Rev. esc. enferm. USP

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“…Study design and characteristics Table 1 lists the methodological elements and outcomes of the 21 papers included, whereas eight were prospective randomized studies [6][7][8][9][10][11][12][13], nine were prospective cohort studies with different (retrospective) control groups [1,[14][15][16][17][18][19][20][21], and four were retrospective chart reviews [22][23][24][25].…”

Section: Study Selectionmentioning

confidence: 99%

“…Eight studies were categorized into the second group [8,[14][15][16][17][18][19]23]. One study was randomized controlled [8] and compared 38 patients in the intervention group with 33 patients in the standard care group.…”

Section: Orthopedic Ward and Daily Consultative Servicementioning

confidence: 99%

“…One study was randomized controlled [8] and compared 38 patients in the intervention group with 33 patients in the standard care group. Five studies were prospective with a retrospective control group [14-16, 18, 19], one was a prospective before and after study [17], and another was a retrospective before and after chart review [23]. All studies were performed on hip fracture patients, whereas one study [15] included all geriatric patients admitted to the orthopedic ward.…”

Section: Orthopedic Ward and Daily Consultative Servicementioning

confidence: 99%

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Ortho-geriatric service—a literature review comparing different models

et al. 2010

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In the fast-growing geriatric population, we are confronted with both osteoporosis, which makes fixation of fractures more and more challenging, and several comorbidities, which are most likely to cause postoperative complications. Several models of shared care for these patients are described, and the goal of our systematic literature research was to point out the differences of the individual models. A systematic electronic database search was performed, identifying articles that evaluate in a multidisciplinary approach the elderly hip fracture patients, including at least a geriatrician and an orthopedic surgeon focused on in-hospital treatment. The different investigations were categorized into four groups defined by the type of intervention. The main outcome parameters were pooled across the studies and weighted by sample size. Out of 656 potentially relevant citations, 21 could be extracted and categorized into four groups. Regarding the main outcome parameters, the group with integrated care could show the lowest in-hospital mortality rate (1.14%), the lowest length of stay (7.39 days), and the lowest mean time to surgery (1.43 days). No clear statement could be found for the medical complication rates and the activities of daily living due to their inhomogeneity when comparing the models. The review of these investigations cannot tell us the best model, but there is a trend toward more recent models using an integrated approach. Integrated care summarizes all the positive features reported in the various investigations like integration of a Geriatrician in the trauma unit, having a multidisciplinary team, prioritizing the geriatric fracture patients, and developing guidelines for the patients' treatment. Each hospital implementing a special model for geriatric hip fracture patients should collect detailed data about the patients, process of care, and outcomes to be able to participate in audit processes and avoid peerlessness.

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