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

Abstract

SummaryWe 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%.PurposeTo characterise inpatient care, complications, and 4-month mortality following a hip or proximal femur fracture in Spain.MethodsDesign: 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.ResultsA 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.ConclusionsDespite 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.Electronic supplementary materialThe online version of this article (10.1007/s11657-018-0515-8) contains supplementary material, which is available to authorized users.

The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study

“…Of the 141 without follow-up data, 99 (9.9%) have died, and 42 (4.2%) were lost to follow-up. Detailed patient characteristics have been previously reported [ 6 ]. Complete data on baseline and 1- and 4-month Barthel and EQ-5D-3L were collected for 824/856 (96.3%) and 746/856 (90.2%) participants respectively.…”

“…Details on sampling strategies, data collection and follow-up have been reported elsewhere [ 6 ]. One thousand consecutive men or women aged ≥ 50 years old with a diagnosis of a fragility femur fracture were recruited.…”

Prediction of Outcome in Patients With Fractures of the Proximal Femur Depending on Medical and Epidemiological and Anamnestic Characteristics

“…20,00 % ( [18]) із 30-денною летальністю на рівні 5,00-10,00 % [19] (5,75 у жінок та 7,95 у чоловіків [20]), причому смертність прогресивно збільшується з віком [21,22]. Серед пацієнтів усіх вікових груп за даними різних авторів смертність через ППВСК сягає до 11,00-23,00 % через 6 місяців [17] та до 22,00-40,00 % на першому році [23], а інвалідність сягає 20,00-50,00 % [24] і оцінюється в 5964 DALI на 1000 осіб [25]. Виходячи з вищевказаного метою нашої роботи постало: вивчення можливостей прогнозування результатів застосування лікувальної тактики пацієнтів із ППВСК в залежності від медикоепідеміологічних та анамнестичних характеристик.…”

Impact of a Postoperative Intervention Educational Program on the Quality of Life of Patients with Hip Fracture: A Randomized, Open-Label Controlled Trial

“…Hip fracture is one of the most important social and health problems, due to its increasing prevalence, health consequences, and economic impact [1]. In Spain, the incidence of hip fractures is…”