Long- Term Outcome of Hip Fracture in Elderly Rural Indian Population

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

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Multi-disciplinary care of the patient with acute hip fracture: How to optimise the care for the elderly, traumatised patient at and around the time of the fracture to ensure the best short-term outcome as a foundation for the best long-term outcome

Best Practice & Research Clinical Rheumatology ◽

10.1016/j.berh.2014.02.003 ◽

2013 ◽

Vol 27 (6) ◽

pp. 717-730 ◽

Cited By ~ 9

Author(s):

Helen Wilson

Keyword(s):

Hip Fracture ◽

The Elderly ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome ◽

Care For The Elderly ◽

Short Term Outcome

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Long-term outcomes after hip fracture in Ireland: a protocol for a systematic review of traditional and grey literature

HRB Open Research ◽

10.12688/hrbopenres.13385.1 ◽

2021 ◽

Vol 4 ◽

pp. 94

Author(s):

Mary E. Walsh ◽

Caitriona Cunningham ◽

Louise Brent ◽

Bibiana Savin ◽

Michelle Fitzgerald ◽

...

Keyword(s):

Systematic Review ◽

Hip Fracture ◽

Data Collection ◽

Grey Literature ◽

Outcome Data ◽

Inpatient Setting ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome

Background: Hip fracture is experienced by almost 3,500 older people in Ireland annually. The Irish Hip Fracture Database (IHFD), which drives clinical improvements in acute hospitals, aims to allow recording of longer-term outcomes. Feasible and robust methods of data collection need to be identified to inform this activity. The aim of this systematic review is to identify, describe and appraise studies that have collected long-term outcomes after hip fracture in Ireland in the last 15 years and to generate pooled estimates of outcomes if appropriate. Methods: A search of electronic databases (MEDLINE, Embase, Scopus, Web of Science and CINAHL) and grey literature sources will be conducted for journal articles, conference abstracts, academic theses, and reports. Search terms related to hip fracture and Ireland will be included for most sources. The search will be supplemented by email contact with relevant professionals. Observational and interventional studies published between 2005 and 2021 will be included if outcome data were collected in the Republic of Ireland in patients with hip fracture. Outcomes of interest will include data collected after discharge from an inpatient setting or at a fixed time-point greater than 30 days after fracture, hospital admission or surgery. Information relating to study characteristics, description of researchers, data collection methods, patient characteristics and long-term outcomes will be extracted from each study and summarised in tables. Studies will be assessed for risk of bias by two review authors. Where outcomes are sufficiently homogeneous, meta-analyses of estimates will be conducted. Conclusion: Results from this study will inform the planning of further qualitative research to explore barriers and facilitators of long-term outcome collection in Ireland. It will form the basis of education and training for future data collectors in this setting.

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Study of mid and long term outcome of hip fracture in elderly operated within 48 hours versus conservative management

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214172 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1070

Author(s):

Delis S. Marshall ◽

Alan S. W. Ch’ng ◽

Irene Looi

Keyword(s):

Social Sciences ◽

Hip Fracture ◽

Descriptive Analysis ◽

Post Intervention ◽

Term Outcome ◽

Long Term Outcome ◽

Conservative Group ◽

Fracture Diagnosis ◽

The Mean

Background: Hip fractures are commonly associated with high morbidities and mortalities. This study aimed to determine post-hip fracture outcomes and survival among patients who underwent operation within 48 hours of fracture diagnosis and among those being treated conservatively.Methods: This retrospective cohort study was conducted at the Hospital Seberang Jaya among patients diagnosed with hip fracture from January to December 2016; confirmed clinical and radiological method. Descriptive analysis was conducted using Statistical package for social sciences (SPSS) version 23.Results: The mean (SD) age of the 61 operated patients was 74 (7.7) years and for the 19 conservatively managed patients 79 (8.0) years. At 12 months, 30 (37.5%) of operated ones, required assisted mobility compared to 8 (10%) of conservatively managed patients. Other outcomes comparable between operated and conservative patients at 12 months post-intervention include: ability to feed on own 46 (57.5%) versus 7 (8.8%), able to dress on own, 45 (56.3%) versus 6 (7.5%); able to bathe on own; 43 (53.8%) versus 2 (2.5%), and independently attending to own toilet needs 44 (55.0%) versus 1 (1.3%). Our study revealed, overall survival were comparatively better among those operated to conservative at 12 months; 52 (85%) versus 9 (47.4%). The mortality at 12 months in the conservative group is much higher than operative group.Conclusions: Ambulatory mobility and survival are significantly better at 12 months post-fracture among the operated patients. Hip fracture must be treated as an emergency and its surgical management given priority.

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