Incidence Rates and Trends of Hip/Femur Fractures in Five European Countries: Comparison Using E-Healthcare Records Databases

Requena, Gema; Abbing‐Karahagopian, Victoria; Huerta, Consuelo; Bruin, Marie L. De; Álvarez, Yolanda; Miret, Montserrat; Hesse, Ulrik; Gardarsdóttir, Helga; Souverein, Patrick C.; Slattery, Jim; Schneider, Cornelia; Rottenkolber, Marietta; Schmiedl, Sven; Gil, Miguel; Groot, Mark de; Bate, Andrew; Ruigómez, Ana; Rodrı́guez, Luis A. Garcı́a; Johansson, Saga; Vries, Frank de; Montero, Dolores; Schlienger, Raymond G.; Reynolds, Robert F.; Klungel, Olaf H.; Abajo, Francisco J. de

doi:10.1007/s00223-014-9850-y

Cited by 38 publications

(43 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hip fractures present a substantial challenge to orthopaedic trauma services, and the incidence is set to rise with the changing population demographic 1 19. Patients often have multiple comorbidities, and mortality rates are high 4.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence in the UK is rising annually and is currently estimated at 10.2 per 10 000 per year. There is an exponential increase with age, which is 2–3 times greater in women 1. The number of patients with a hip fracture in the UK is therefore estimated to rise, given the aging population, from ∼75 000 patients per year currently to 91 500 in 2015 and 10 100 in 2020 2…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving the care of patients with a hip fracture: a quality improvement report

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving the care of patients with a hip fracture: a quality improvement report

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Similarly, antidepressant use and hip fracture risk was explored only in a literature review [17]. A second published study in the WP2 program examined femur/hip fracture rates using European electronic health record databases but did not report on any possible association with drug treatment [18].…”

Section: European Protect Projectmentioning

confidence: 99%

“…In a PROTECT study of the incidence of hip fractures [18], investigators needed widely varying event definitions. Two countries were using ICD-10 codes and required nine different codes to identify hip fracture events; two databases used International Classification of Primary Care (ICPC-2) using just one code; and two databases used the UK's Read terminology and had to specify 110 codes.…”

Section: Terminology Problemsmentioning

confidence: 99%

Electronic Health Data for Postmarket Surveillance: A Vision Not Realized

Moore

Furberg

2015

Drug Saf

View full text Add to dashboard Cite

What has been learned about electronic health data as a primary data source for regulatory decisions regarding the harms of drugs? Observational studies with electronic health data for postmarket risk assessment can now be conducted in Europe and the US in patient populations numbering in the tens of millions compared with a few hundred patients in a typical clinical trial. With standard protocols, results can be obtained in a few months; however, extensive research published by scores of investigators has illuminated the many obstacles that prevent obtaining robust, reproducible results that are reliable enough to be a primary source for drug safety decisions involving the health and safety of millions of patients. The most widely used terminology for coding patient interactions with medical providers for payment has proved illsuited to identifying the adverse effects of drugs. Directly conflicting results were reported in otherwise similar patient health databases, even using identical event definitions and research methods. Evaluation of some accepted statistical methods revealed systematic bias, while others appeared to be unreliable. When electronic health data studies detected no drug risk, there were no robust and accepted standards to judge whether the drug was unlikely to cause the adverse effect or whether the study was incapable of detecting it. Substantial investment and careful thinking is needed to improve the reliability of risk assessments based on electronic health data, and current limitations need to be fully understood. Key PointsElectronic health data for postmarket surveillance became a key element in the new paradigm for drug regulation, which involved fewer and smaller clinical trials prior to marketing approval.The research programs and pilot systems created to study harms of licensed drugs proved largely unable to provide credible evidence of new, unsuspected drug adverse effects, and conflicting and contradictory results when seeking to confirm known harms.Major problems included a limited underlying terminology, few validation studies, and the need for additional statistical standards for these complex data.

show abstract

“…Hip fracture is a frequent surgical procedure among the elderly 1. It correlates with high medical costs and health care utilization2 and confers increased risk of mortality 3.…”

Section: Introductionmentioning

confidence: 99%

Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study

Bruun¹,

Petersen²,

Kristensen³

et al. 2018

CLEP

View full text Add to dashboard Cite

PurposeTo examine the association between selective serotonin reuptake inhibitor (SSRI) use and mortality, postoperative complications, and quality of in-hospital care in hip fracture patients.Patients and methodsThe study was a nationwide cohort study based on individual-level linked, prospectively collected data from Danish population-based national registries covering all hospitals in Denmark. The health care system in Denmark is tax-funded, and all citizens have equal access to health care services. We included patients with first-time hospitalization due to hip fracture undergoing surgery from 2006–2016. We estimated the risk of 30-day mortality, any unplanned readmission, any reoperation, specific postoperative complications including cardiovascular events and major bleeding, and quality of in-hospital care using Cox and Poisson regression analyses comparing current and former SSRI users with non-users.ResultsIn 68,487 hip fracture patients, 13,272 (19%) were current SSRI users, 2,777 (4%) were former SSRI users, and 52,438 (77%) were SSRI non-users. The 30-day mortality risk was 13% in current SSRI users (HR 1.16, 1.10–1.21) and 12% in former (HR 1.15, 1.04–1.27) compared with 10% in non-users. The HR for any unplanned readmission was 1.11 (1.02–1.20) in current and 1.13 (1.01–1.27) in former SSRI users and for any reoperation 1.21 (1.11–1.31) in current and 1.04 (0.84–1.28) in former SSRI users compared with non-users. The risk of venous thromboembolism, myocardial infarction, stroke, and bleeding were similar irrespective of SSRI use. No association between current and former SSRI use and quality of in-hospital care was found.ConclusionIn patients undergoing hip fracture surgery, 30-day mortality and overall readmission risk were elevated in both current and former SSRI users compared with non-users. Those currently using SSRI had a 26% increased reoperation risk compared with non-users. However, SSRI use was not associated with increased risk of other postoperative complications and lower quality of in-hospital care. A limitation of this study was the inability to control for potential confounding of social deprivation.

show abstract

Incidence Rates and Trends of Hip/Femur Fractures in Five European Countries: Comparison Using E-Healthcare Records Databases

Cited by 38 publications

References 36 publications

Improving the care of patients with a hip fracture: a quality improvement report

Improving the care of patients with a hip fracture: a quality improvement report

Electronic Health Data for Postmarket Surveillance: A Vision Not Realized

Selective serotonin reuptake inhibitor use and mortality, postoperative complications, and quality of care in hip fracture patients: a Danish nationwide cohort study

Contact Info

Product

Resources

About