Variation in care and outcome for fragile hip fracture patients : a European multicentre study benchmarking fulfilment of established quality indicators
Coeckelberghs, E. (European Pathway Association (Leuven, Bèlgica))
Vanhaecht, K. (UZ Leuven)
Akiki, A. (Hôpital Riviera Chablais (Rennaz, Suïssa))
Castillón-Bernal, Pablo (Universitat Autònoma de Barcelona)
Cox, B. (Leuven Institute for Healthcare Policy)
Attal, R El (Landeskrankenhaus Feldkirch (Feldkirch, Austria))
Foss, NB. (University of Copenhagen)
Frihagen, F. (University of Oslo)
Gerich, TG. (Centre Hospitalier de Luxembourg)
Kanakaris, NK. (University of Leeds)
Kristensen, MT. (University of Copenhagen)
Mohaddes, M. (Sahlgrenska University Hospital (Mölndal, Suècia))
Panella, M. (University of Eastern Piedmont (Novara, Itàlia))
Pape, HC. (University of Zurich)
Sermon, A. (UZ Leuven)
Seys, D. (Leuven Institute for Healthcare Policy)
Nijs, S. (UZ Leuven)

Data:	2024
Resum:	Despite the availability of clinical guidelines for hip fracture patients, adherence to these guidelines is challenging, potentially resulting in suboptimal patient care. The goal of this study was (1) to evaluate and benchmark the adherence to recently established quality indicators (QIs), and (2) to study clinical outcomes, in fragile hip fracture patients from different European countries. This observational, cross-sectional multicenter study was performed in 10 hospitals from 9 European countries including data of 298 consecutive patients. A large variation both within and between hospitals were seen regarding adherence to the individual QIs. QIs with the lowest overall adherence rates were the administration of systemic steroids (5. 4%) and tranexamic acid (20. 1%). Indicators with the highest adherence rates (above 95%) were pre-operative (99. 3%) and post-operative haemoglobin level assessment (100%). The overall median time to surgery was 22. 6 h (range 15. 7-42. 5 h). The median LOS was 9. 0 days (range 5. 0-19. 0 days). The most common complications were delirium (23. 2%) and postsurgical constipation (25. 2%). The present study shows large variation in the care for fragile patients with hip fractures indicating room for improvement. Therefore, hospitals should invest in benchmarking and knowledge-sharing. Large quality improvement initiatives with longitudinal follow up of both process and outcome indicators should be initiated.
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:	Fragile hip fracture ; Quality of care ; Variation ; Care process
Publicat a:	European Journal of Trauma and Emergency Surgery, Vol. 50 (may 2024) , p. 2421-2430, ISSN 1863-9941

DOI: 10.1007/s00068-024-02549-0
PMID: 38819678

10 p, 1.4 MB

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