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, Daniel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Reyes, Carles (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Sainz, Miguel Sanz (Instituto de Investigación Sanitaria de Aragón)
González-Macías, Jesús (Instituto de Investigación Sanitaria Valdecilla (Santander, Cantàbria))
Delgado, Luis Gracia (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Bouzón, Cristina Alonso (Hospital Universitario de Getafe (Madrid))
Gañan, Sarah Mills (Hospital Universitario La Paz (Madrid))
Miedes, Damián Mifsut (Hospital Clínic Universitari (València))
Vaquero-Cervino, Eduardo (Complejo Hospitalario Universitario de Pontevedra)
Bardaji, Manuel Francisco Bravo (Hospital Regional Universitario de Málaga)
Ezquerra, Laura (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Baztán, Fátima Brañas (Hospital Universitario Infanta Leonor)
Ferrer, Bartolomé Lladó (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Perez-Coto, Ivan (Hospital Universitario San Agustín (Avilés))
Bueno, Gaspar Adrados (Hospital Infanta Cristina)
Mora-Fernandez, Jesús (Hospital Clínico San Carlos (Madrid))
Doñate, Teresa Espallargas (Hospital Obispo Polanco)
Martínez-Iñiguez Blasco, J. (Hospital San Pedro de Alcántara)
Aguado-Maestro, Ignacio (Hospital Universitario Río Hortega (Valladolid))
Sáez-López, Pilar (Instituto de Investigación Sanitaria del Hospital Universitario La Paz)
Salomó-Domènech, M (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Climent-Peris, Vicente (Traumatology and Orthopaedics Unit, Hospital Públic Lluis Alcanyis de Xàtiva (Valencia))
Díez Rodríguez, Ángel (Hospital Virgen del Puerto (Cáceres))
Sardiñas, Humberto Kessel (Complejo Hospitalario Torrecárdenas (Almeria))
Gómez, Óscar Tendero (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Serra, Jordi Teixidor (Hospital Universitari Vall d'Hebron)
Caeiro Rey, José Ramón (Complejo Hospitalario Universitario de Santiago de Compostela)
Cano, Ignacio Andrés (Hospital Universitario Puerta del Mar (Cadis, Andalusia))
Carsi, Mariano Barrés (Hospital Universitari i Politècnic La Fe (València))
Etxebarria-Foronda, Iñigo (Department of Orthopaedic, Alto Deba Hospital, Arrasate-Mondragon (Gipuzkoa))
Hernández, Juan Dionisio Avilés (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Solis, Juan Rodriguez (Hospital Universitario de Guadalajara)
Suau, Oscar Torregrosa (Hospital General Universitario de Elche)
Nogués Solán, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Herrera, Antonio (Universidad de Zaragoza)
Díez Pérez, Adolfo (Institut Hospital del Mar d'Investigacions Mèdiques)
Universitat Autònoma de Barcelona

Data:	2018
Resum:	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%. To characterise inpatient care, complications, and 4-month mortality following a hip or proximal femur fracture in Spain. 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. 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. Despite suboptimal surgical delay, post-hip fracture mortality is low in Spanish hospitals. The secondary fracture prevention gap is unacceptably high at.
Nota:	Altres ajuts: DPA is funded by a National Institute for Health Research Clinician Scientist award (CS-2013-13-012). This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. This work was supported by the NIHR Biomedical Research Centre, Oxford. Funded in part by CIBER on Frailty and Healthy Aging (CIBERFES), Instituto Carlos III, Spanish Ministry of Economy and Competitiveness, FEDER funds. Unrestricted research grant from Amgen S.A. Amgen did not have any role in study design, collection, analysis and interpretation of data, writing the report, and the decision to submit the report for publication.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hip fracture ; Registries ; Osteoporosis and patient care management
Publicat a:	Archives of Osteoporosis, Vol. 13 (september 2018) , ISSN 1862-3514

DOI: 10.1007/s11657-018-0515-8
PMID: 30218380

11 p, 619.1 KB

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