TY - JOUR
T1 - 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
AU - Prieto-Alhambra, Daniel
AU - Reyes, Carlen
AU - Sainz, Miguel Sanz
AU - González-Macías, Jesús
AU - Delgado, Luis Gracia
AU - Bouzón, Cristina Alonso
AU - Gañan, Sarah Mills
AU - Miedes, Damián Mifsut
AU - Vaquero-Cervino, Eduardo
AU - Bardaji, Manuel Francisco Bravo
AU - Herrando, Laura Ezquerra
AU - Baztán, Fátima Brañas
AU - Ferrer, Bartolomé Lladó
AU - Perez-Coto, Ivan
AU - Bueno, Gaspar Adrados
AU - Mora-Fernandez, Jesús
AU - Doñate, Teresa Espallargas
AU - Blasco, Jorge Martínez Iñiguez
AU - Aguado-Maestro, Ignacio
AU - Sáez-López, Pilar
AU - Doménech, Monica Salomó
AU - Climent-Peris, Vicente
AU - Rodríguez, Ángel Díez
AU - Sardiñas, Humberto Kessel
AU - Gómez, Óscar Tendero
AU - Serra, Jordi Teixidor
AU - Caeiro-Rey, José Ramón
AU - Cano, Ignacio Andrés
AU - Carsi, Mariano Barrés
AU - Etxebarria-Foronda, Iñigo
AU - Hernández, Juan Dionisio Avilés
AU - Solis, Juan Rodriguez
AU - Suau, Oscar Torregrosa
AU - Nogués, Xavier
AU - Herrera, Antonio
AU - Díez-Perez, Adolfo
PY - 2018/12/1
Y1 - 2018/12/1
N2 - © 2018, The Author(s). 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 anti-thrombotic and antibiotic prophylaxis.
AB - © 2018, The Author(s). 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 anti-thrombotic and antibiotic prophylaxis.
KW - Hip fracture
KW - Osteoporosis and patient care management
KW - Registries
U2 - https://doi.org/10.1007/s11657-018-0515-8
DO - https://doi.org/10.1007/s11657-018-0515-8
M3 - Article
C2 - 30218380
VL - 13
M1 - 96
ER -