Pablo Castillón1, Jorge H Nuñez2,3, Fatima Mori-Gamarra4, Cristina Ojeda-Thies5, Pilar Sáez-López6,7,8, Jordi Salvador1, Francesc Anglés1,9, Juan Ignacio González-Montalvo6,10. 1. Department of Traumatology and Orthopaedic Surgery, University Hospital of Mutua Terrasa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain. 2. Department of Traumatology and Orthopaedic Surgery, University Hospital of Mutua Terrasa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain. hassan2803med@gmail.com. 3. Department of Traumatology and Orthopaedic Surgery, University Hospital of Vall d' Hebron, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain. hassan2803med@gmail.com. 4. Complexo Hospitalario Universitario de Ourense, Calle Ramón Puga Noguerol, 54, 32005, Ourense, Spain. 5. Department of Traumatology and Orthopaedic Surgery, University Hospital of 12 de Octubre, Av. Córdoba s/n, 28041, Madrid, Spain. 6. Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain. 7. Hospital Universitario Fundación Alcorcón, Madrid, Spain. 8. Spanish National Hip Fracture Registry, Madrid, Spain. 9. Departament de Cirurgia Universitat de Barcelona, Barcelona, Spain. 10. Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Abstract
Although medicine is currently protocol-based, there are still differences in the management of the hip fracture in Spain, especially regarding surgical delay, type of anesthesia, early mobilization, and discharge destinations. This data will be of great value to assist stakeholders in formulating health policies. PURPOSE: Analysis of demographic, clinical, surgical, and functional data of the Spanish National Hip Fracture National Registry (RNFC), during admission and at 1-month follow-up, by Autonomous Communities (ACs). METHODS: Cross-sectional analysis in the framework of a RNFC cohort, from January 2017 to May 2018, including 15 ACs from Spain, with 1 month of follow-up. Sociodemographic, clinical, surgical, and outcome variables were analyzed. RESULTS: In total, 13,839 patients were analyzed. There were significant differences (p <0.001) in median surgical delay and percentage of patients operated in less than 48 h. Mean surgical delay was 70.75 h, with a 12-h difference between the Communities of Madrid (71.22) and Catalonia (59.65). Only 43% of patients had less than 48-h delay. Overall, most patients received regional anesthesia (91.9%); however, there was a significant difference between ACs (p = 0.0001). There were also differences in inpatient stay, early mobilization, discharge destination, and mortality (p <0.001). Mortality 30 days after surgery was 7.8%, and highest in the Basque Country (12.5%). CONCLUSIONS: The registry showed homogeneity among ACs regarding sociodemographic variables, fracture type, surgical treatment, ASA risk, and co-management with a geriatrician or an integrated internist. There were significant differences in hip fracture management between ACs in Spain, especially regarding surgical delay, type of anesthesia, early mobilization, and discharge destinations.
Although medicine is currently protocol-based, there are still differences in the management of the hip fracture in Spain, especially regarding surgical delay, type of anesthesia, early mobilization, and discharge destinations. This data will be of great value to assist stakeholders in formulating health policies. PURPOSE: Analysis of demographic, clinical, surgical, and functional data of the Spanish National Hip Fracture National Registry (RNFC), during admission and at 1-month follow-up, by Autonomous Communities (ACs). METHODS: Cross-sectional analysis in the framework of a RNFC cohort, from January 2017 to May 2018, including 15 ACs from Spain, with 1 month of follow-up. Sociodemographic, clinical, surgical, and outcome variables were analyzed. RESULTS: In total, 13,839 patients were analyzed. There were significant differences (p <0.001) in median surgical delay and percentage of patients operated in less than 48 h. Mean surgical delay was 70.75 h, with a 12-h difference between the Communities of Madrid (71.22) and Catalonia (59.65). Only 43% of patients had less than 48-h delay. Overall, most patients received regional anesthesia (91.9%); however, there was a significant difference between ACs (p = 0.0001). There were also differences in inpatient stay, early mobilization, discharge destination, and mortality (p <0.001). Mortality 30 days after surgery was 7.8%, and highest in the Basque Country (12.5%). CONCLUSIONS: The registry showed homogeneity among ACs regarding sociodemographic variables, fracture type, surgical treatment, ASA risk, and co-management with a geriatrician or an integrated internist. There were significant differences in hip fracture management between ACs in Spain, especially regarding surgical delay, type of anesthesia, early mobilization, and discharge destinations.
Entities:
Keywords:
Hip fracture; Hip fracture registry; Mortality; Outcomes; Variability of care
Authors: M Jesús Molina Hernández; Cristina González de Villaumbrosia; Elisa Martín de Francisco de Murga; Teresa Alarcón Alarcón; Nuria Montero-Fernández; Julia Illán; Rafael Bielza; Jesús Mora-Fernández Journal: Rev Esp Geriatr Gerontol Date: 2018-08-18
Authors: P Sáez-López; J I González-Montalvo; C Ojeda-Thies; J Mora-Fernández; A Muñoz-Pascual; J M Cancio; F J Tarazona; T Pareja; P Gómez-Campelo; N Montero-Fernández; T Alarcón; P Mesa-Lampre; R Larrainzar-Gar; E Duaso; E Gil-Garay; A Diéz-Pérez; D Prieto-Alhambra; R Queipo-Matas; A Otero-Puime Journal: Rev Esp Geriatr Gerontol Date: 2018-02-14
Authors: P Sáez-López; F Brañas; N Sánchez-Hernández; N Alonso-García; J I González-Montalvo Journal: Osteoporos Int Date: 2016-11-21 Impact factor: 4.507
Authors: Jenny Neuburger; Colin Currie; Robert Wakeman; Carmen Tsang; Fay Plant; Bianca De Stavola; David A Cromwell; Jan van der Meulen Journal: Med Care Date: 2015-08 Impact factor: 2.983
Authors: Irene Papanicolas; Kristen Riley; Olukorede Abiona; Mina Arvin; Femke Atsma; Enrique Bernal-Delgado; Nicholas Bowden; Carl Rudolf Blankart; Sarah Deeny; Francisco Estupiñán-Romero; Robin Gauld; Philip Haywood; Nils Janlov; Hannah Knight; Luca Lorenzoni; Alberto Marino; Zeynep Or; Anne Penneau; Andrew J Schoenfeld; Kosta Shatrov; Mai Stafford; Onno van de Galien; Kees van Gool; Walter Wodchis; Ashish K Jha; Jose F Figueroa Journal: Health Serv Res Date: 2021-08-11 Impact factor: 3.402