scholarly journals Achieving best practice tariff may not reflect improved survival after hip fracture treatment

2014 ◽  
pp. 2097 ◽  
Author(s):  
Khan ◽  
Mark Shirley ◽  
Clare Glennie ◽  
Paul Fearon ◽  
David Deehan
Keyword(s):  
Hip Fracture ◽  
Best Practice ◽  
Fracture Treatment

scholarly journals Hip fracture treatment in Norway

2020 ◽  
Vol 1 (10) ◽  
pp. 644-653
Author(s):  
Cato Kjærvik ◽  
Eva Stensland ◽  
Hanne Sigrun Byhring ◽  
Jan-Erik Gjertsen ◽  
Eva Dybvik ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Best Practice ◽  
Treatment Guidelines ◽  
Treatment Recommendations ◽  
Femoral Neck Fractures ◽  
Evidence Based ◽  
Fracture Treatment ◽  
One Year

Aims The aim of this study was to describe variation in hip fracture treatment in Norway expressed as adherence to international and national evidence-based treatment guidelines, to study factors influencing deviation from guidelines, and to analyze consequences of non-adherence. Methods International and national guidelines were identified and treatment recommendations extracted. All 43 hospitals routinely treating hip fractures in Norway were characterized. From the Norwegian Hip Fracture Register (NHFR), hip fracture patients aged > 65 years and operated in the period January 2014 to December 2018 for fractures with conclusive treatment guidelines were included (n = 29,613: femoral neck fractures (n = 21,325), stable trochanteric fractures (n = 5,546), inter- and subtrochanteric fractures (n = 2,742)). Adherence to treatment recommendations and a composite indicator of best practice were analyzed. Patient survival and reoperations were evaluated for each recommendation. Results Median age of the patients was 84 (IQR 77 to 89) years and 69% (20,427/29,613) were women. Overall, 79% (23,390/29,613) were treated within 48 hours, and 80% (23,635/29,613) by a surgeon with more than three years’ experience. Adherence to guidelines varied substantially but was markedly better in 2018 than in 2014. Having a dedicated hip fracture unit (OR 1.06, 95%CI 1.01 to 1.11) and a hospital hip fracture programme (OR 1.16, 95% CI 1.06 to 1.27) increased the probability of treatment according to best practice. Surgery after 48 hours increased one-year mortality significantly (OR 1.13, 95% CI 1.05 to 1.22; p = 0.001). Alternative treatment to arthroplasty for displaced femoral neck fractures (FNFs) increased mortality after 30 days (OR 1.29, 95% CI 1.03 to 1.62)) and one year (OR 1.45, 95% CI 1.22 to 1.72), and also increased the number of reoperations (OR 4.61, 95% CI 3.73 to 5.71). An uncemented stem increased the risk of reoperation significantly (OR 1.23, 95% CI 1.02 to 1.48; p = 0.030). Conclusion Our study demonstrates a substantial variation between hospitals in adherence to evidence-based guidelines for treatment of hip fractures in Norway. Non-adherence can be ascribed to in-hospital factors. Poor adherence has significant negative consequences for patients in the form of increased mortality rates at 30 and 365 days post-treatment and in reoperation rates. Cite this article: Bone Joint Open 2020;1-10:644–653.

scholarly journals Cost comparison in hip fracture treatment

1991 ◽  
Vol 62 (sup241) ◽  
pp. 38-39 ◽  
Author(s):  
Karl-GÖRan Thorngren
Keyword(s):  
Hip Fracture ◽  
Cost Comparison ◽  
Fracture Treatment

Effect of occupational therapy on functional and emotional outcomes after hip fracture treatment: a randomized controlled trial

2013 ◽  
Vol 28 (6) ◽  
pp. 541-551 ◽  
Author(s):  
Lydia M Martín-Martín ◽  
Gerald Valenza-Demet ◽  
José Juan Jiménez-Moleón ◽  
Irene Cabrera-Martos ◽  
Francisco Javier Revelles-Moyano ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Occupational Therapy ◽  
Controlled Trial ◽  
Fracture Treatment ◽  
Randomized Controlled ◽  
Emotional Outcomes

scholarly journals Factors determining eligibility and access to subacute rehabilitation for elderly people with dementia and hip fracture

Dementia ◽  
2015 ◽  
Vol 16 (4) ◽  
pp. 413-423 ◽  
Author(s):  
Rosemary A McFarlane ◽  
Stephen T Isbel ◽  
Maggie I Jamieson
Keyword(s):  
Hip Fracture ◽  
Best Practice ◽  
Inpatient Rehabilitation ◽  
Models Of Care ◽  
Cochrane Library ◽  
Ageing Population ◽  
Barriers To Access ◽  
People With Dementia ◽  
Vulnerable Patients ◽  
The Cochrane Library

With hip fracture and dementia increasing in incidence in the global ageing population, there is a need for the development of specific procedures targeting optimal treatment outcomes for these patients. This paper looks primarily at the factors that limit access to subacute rehabilitation services as a growing body of evidence suggests that access to timely inpatient rehabilitation increases functional outcomes for patients both with dementia and without. Information was gathered by searching electronic data bases (SCOPUS, Medline, CINAHL, Health Source Nursing/Academic Addition, Psychinfo and the Cochrane Library) for relevant articles using the search terms dementia OR Alzheimer* AND hip fracture AND subacute rehabilitation OR convalescence for the period 2005–2015. Abstracts were scanned to identify articles discussing eligibility and access. A total of nine papers were identified that directly addressed this topic. Other papers discussing success or failure of rehabilitation and improved models of care were also reviewed. Barriers to access discussed in the literature include information management, management of comorbidities, attitudes, resource availability, and the quality of evidence and education. By identifying these factors we can identify strategic points of intervention across the trajectory of prevention, treatment and rehabilitation that may improve outcomes for this growing group of vulnerable patients. Emerging best practice for these patients is also discussed.

Iatrogenic Arterial Trauma Associated with Hip Fracture Treatment

2000 ◽  
Vol 48 (5) ◽  
pp. 957-959 ◽  
Author(s):  
Remmert K. Storm ◽  
Aa K. Sing ◽  
Eelco J. R. de Graaf ◽  
Geert W. M. Tetteroo
Keyword(s):  
Hip Fracture ◽  
Fracture Treatment ◽  
Arterial Trauma

Comparing Properties of Audit Data and Routinely Collected Register Data in Case of Performance Assessment of Hip Fracture Treatment in Finland

2007 ◽  
Vol 46 (05) ◽  
pp. 558-566 ◽  
Author(s):  
I. Nurmi-Lüthje ◽  
P. Lüthje ◽  
S. Tanninen ◽  
A. Narinen ◽  
I. Keskimäki ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Performance Assessment ◽  
Register Data ◽  
Fracture Treatment ◽  
Prospective Audit ◽  
Quality Of Data ◽  
Fracture Event ◽  
Audit Data ◽  
Clinical Detail

Summary Objectives: To compare prospective audit data and secondary administrative register data in the production of performance assessment information in the case of hip fracture treatment, and to cross-validate the quality of information. Methods: First, a conceptual model for the performance assessment of hip fracture treatment was defined. This model was then utilized in comparisons between the prospective audit data concerning 106 consecutive hip fracture patients from the Kuusankoski Regional Hospital and corresponding register data from the Finnish Health Care Register and the Causes of Death Register. We examined the completeness of registration of patients and also the accuracy and degree of completeness of the registered data. Observed differences were checked against the medical records. Results: Register data lack clinical detail, but outperform prospective data in the recording of inpatient care history. Completeness of the register data is very good. The accuracy of easily measurable variables in the register is at least 95%. The agreement between register and audit data was 86.3% for detailed hip fracture diagnosis. Polyserial correlation between the functional dependency variables was 0.68. Conclusions: Register and audit data have certain limitations and problems, but both seem to be suitable for the performance assessment of hip fracture treatment. To improve the feasibilityof the administrative register data, the voluntary input of additional hip fracture event data to the register should be made possible. Standardized instructions that guide the use of available register classifications in a sensible way would improvethe quality of data.

scholarly journals Disparities in length of stay for hip fracture treatment between patients treated in safety-net and non-safety-net hospitals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Edward Coffield ◽  
Saeyoan Thirunavukkarasu ◽  
Emily Ho ◽  
Swapna Munnangi ◽  
L.D. George Angus
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Safety Net ◽  
Fracture Treatment
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