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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

Data de publicació:

Autors de IIS La Fe

Autors aliens a IIS La Fe

  • Prieto-Alhambra, D
  • Reyes, C
  • Sainz, MS
  • Gonzalez-Macias, J
  • Delgado, LG
  • Bouzon, CA
  • Ganan, SM
  • Miedes, DM
  • Vaquero-Cervino, E
  • Bardaji, MFB
  • Herrando, LE
  • Baztan, FB
  • Ferrer, BL
  • Perez-Coto, I
  • Bueno, GA
  • Mora-Fernandez, J
  • Donate, TE
  • Blasco, JMI
  • Aguado-Maestro, I
  • Saez-Lopez, P
  • Domenech, MS
  • Climent-Peris, V
  • Rodriguez, AD
  • Sardinas, HK
  • Gomez, OT
  • Serra, JT
  • Caeiro-Rey, JR
  • Cano, IA
  • Etxebarria-Foronda, I
  • Hernandez, JDA
  • Solis, JR
  • Suau, OT
  • Nogues, X
  • Herrera, A
  • Diez-Perez, A

Abstract

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.

Dades de la publicació

ISSN/ISSNe:
1862-3522, 1862-3514

Archives of Osteoporosis  SPRINGER LONDON LTD

Tipus:
Article
Pàgines:
96-96
PubMed:
30218380
Factor d'Impacte:
0,813 SCImago ℠
Quartil:
Q2 SCImago ℠

Cites Rebudes en Web of Science: 27

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Keywords

  • Hip fracture; Registries; Osteoporosis and patient care management

Projectes associats

ESTUDIO EN FASE IIIB MULTICÉNTRICO, ALEATORIZADO, DOBLE CIEGO Y CONTROLADO, PARA EVALUAR LA EFICACIA Y SEGURIDAD DE RIVAROXABAN 10 MG FRENTE A ENOXAPARINA 4.000 UI PARA LA PROFILAXIS DE TEV EN CIRUGÍA ORTOPÉDICA MENOR. ESTUDIO PRONOMOS.

Investigador Principal: FRANCISCO BAIXAULI GARCÍA

1408143 . 2017

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