| Title: |
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 |
| Authors: |
Prieto-Alhambra, D; Reyes, C; Sainz, M; González-Macías, J; Delgado, L; Bouzón, C; Gañan, S; Miedes, D; Vaquero-Cervino, E; Bardaji, MF; Herrando, L; Baztán, F; Ferrer, B; Perez-Coto, I; Bueno, G; Mora-Fernandez, J; Doñate, T; Blasco, J; Aguado-Maestro, I; Sáez-López, P; Doménech, M; Climent-Peris, V; Rodríguez, A; Sardiñas, H; Gómez, O; Serra, J; Caeiro-Rey, JR; Cano, I; Carsi, M; Etxebarria-Foronda, I; Hernández, JD; Solis, J; Suau, O; Nogués, X; Herrera, A; Díez-Perez, A |
| Publisher Information: |
Springer London |
| Publication Year: |
2018 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Summary We 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%. Purpose To characterise inpatient care, complications, and 4-month mortality following a hip or proximal femur fracture in Spain. Methods Design: 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. Results A 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. Conclusions Despite 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 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| DOI: |
10.1007/s11657-018-0515-8 |
| Availability: |
https://doi.org/10.1007/s11657-018-0515-8; https://ora.ox.ac.uk/objects/uuid:8c5fe0a1-4ab4-4251-a8ea-ae94d7ea6cc3 |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| Accession Number: |
edsbas.899EB83B |
| Database: |
BASE |