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

Prieto-Alhambra, D. ; Reyes, C. ; Sanz Sainz, M. ; Gonzalez-Macias, J. ; Delgado, L.G. ; Bouzon, C.A. ; Ganan, S.M. ; Miedes, D.M. ; Vaquero-Cervino, E. ; Bardaji, M.F.B. ; Ezquerra Herrando, L. ; Baztan, F.B. ; Ferrer, B.L. ; Perez-Coto, I. ; Bueno, G.A. ; Mora-Fernandez, J. ; Donate, T.E. ; Blasco, J.M.I. ; Aguado-Maestro, I. ; Saez-Lopez, P. ; Domenech, M.S. ; Climent-Peris, V. ; Rodriguez, A.D. ; Sardinas, H.K. ; Gomez, O.T. ; Serra, J.T. ; Caeiro-Rey, J.R. ; Cano, I.A. ; Carsi, M.B. ; Etxebarria-Foronda, I. ; Hernandez, J.D.A. ; Solis, J.R. ; Suau, O.T. ; Nogues, X. ; Herrera, A. (Universidad de Zaragoza) ; Diez-Perez, A.

Resumen: 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.

Idioma: Inglés

DOI: 10.1007/s11657-018-0515-8

Año: 2018

Publicado en: Archives of Osteoporosis 13, 1 (2018), 96 [11 pp]
ISSN: 1862-3522

Factor impacto JCR: 2.469 (2018)

Categ. JCR: ORTHOPEDICS rank: 24 / 76 = 0.316 (2018) - Q2 - T1
Categ. JCR: ENDOCRINOLOGY & METABOLISM rank: 93 / 145 = 0.641 (2018) - Q3 - T2

Factor impacto SCIMAGO: 0.813 - Orthopedics and Sports Medicine (Q2)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Traumatología y Ortopedia (Dpto. Cirugía,Ginecol.Obstetr.)