scholarly journals Elderly Patients with Pertrochanteric Hip Fracture: In Hospital Care

2019 ◽  
Vol 3 (4) ◽  
pp. 1-8
Author(s):  
Faour Martín O
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Cost Reduction ◽  
Hospital Care ◽  
Scientific Evidence ◽  
Clinical Results ◽  
Fracture Management ◽  
Care Of Elderly

Objective: To evaluate the improvement in the care of elderly patients hospitalized due to pertrochanteric hip fractures. Methods: A comparative study of two cohorts of patients admitted due to pertrochanteric hip fractu re before (2010) and after the application of in hospital management protocols (2018). The intervention consisted in the implementation of multidisciplinary measures during hospitalization based on current scientific evidence. An evaluation of the clinical results was performed, as well as the health care impact. Results: The characteristics of patients admitted for hip fracture in 2010 (216 patients) and 2018 (205 patients) were similar in age, sex, Barthel index and the Charlson abbreviated index. In 2018 patients had more comorbidity. A significant reduction of preoperative stay and overall stay in the cohort of 2018 was achieved. Detection of delirium, malnutrition and anaemia was higher in 2018, and a reduced incidence of infection and a better function al efficiency was achieved in this period. Conclusion: The introduction of measures for the improvement of the pertrochanteric hip fracture management reduces hospitalization with consequent cost reduction. Unification of criteria among professionals may b e an opportunity for better clinical results and reduction of complications.

The Care of Elderly Patients with Hip Fracture

1988 ◽  
Vol 319 (21) ◽  
pp. 1392-1397 ◽  
Author(s):  
John F. Fitzgerald ◽  
Patricia S. Moore ◽  
Robert S. Dittus
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Care Of Elderly

scholarly journals The Benefits of Streamlined Hip Fracture Management in a Regional Hospital

2017 ◽  
Vol 8 (2) ◽  
pp. 99-103 ◽  
Author(s):  
T. C. Mow ◽  
Jen Lukeis ◽  
A. G. Sutherland
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Performance Indicator ◽  
Cost Benefit ◽  
Standard Of Care ◽  
Regional Hospital ◽  
Time To Surgery ◽  
Fracture Management ◽  
The Impact

Introduction: Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. Methods: Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment. A hip fracture working group was created to examine closely the process of hip fracture care, and a single key performance indicator (KPI) of “surgery within 48 hours” was adopted. This allowed identification of processes that could be clarified and streamlined, with the agreement of relevant stakeholders, in the creation of a new hip fracture pathway. Results: In the first 3 months of the pathway’s implementation, 16 of 18 patients had surgery within 48 hours of presentation. In a 6-month follow-up audit after 2 years of implementation, 36 of 39 patients were treated within 48 hours. This was significantly different to the time to surgery seen in the 12 months prior to the redesign ( P < .001, Student t test). The mean time to surgery was reduced from 72 hours to 36 hours, a saving in an annual acute bed stay cost of A$152 000. Discussion: Decreased time to the operating room, the cost savings inherent to this, can be achieved with the introduction of the best standard of care. A redesign that mandates collaboration in achieving a single KPI has allowed a significant culture shift in the treatment of hip fractures in our institution in the months following its institution. Conclusion: Collaborative, multidisciplinary collaboration has facilitated a higher standard of care and demonstrated significant cost benefit.

Rehabilitation of elderly patients in the community following surgery for hip fracture – utilization of personal and health care services

2011 ◽  
Vol 34 (10) ◽  
pp. 811-816 ◽  
Author(s):  
Sophia Eilat-Tsanani ◽  
Hava Tabenkin ◽  
Basil Kaufman ◽  
Idit Lavie ◽  
Zvi Weiss ◽  
...  
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Health Care Services ◽  
Care Services

scholarly journals Observation on the risk of falling and self-efficacy in elderly patients with hip fracture

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Zongyou Mou ◽  
Ke Song ◽  
Jinquan Guo
Keyword(s):  
High School ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Self Efficacy ◽  
School Education ◽  
High School Education ◽  
Risk Of Falling ◽  
Post Surgery ◽  
Number Of Patients

Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture. Methodology: Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from April 2018 to April 2019, and were enrolled into this study. All patients were assessed by using the Morse Fall Scale (MFS) and Falls Efficacy Scale(FES).The basic situation of the patients with hip fractures caused by falling and the scores of MFS and FES before and after falling were evaluated. Results: Results showed that the number of patients with femoral neck fractures accounted for 70% out of all patients, and the number of patients with intertrochanteric fractures accounted for the remaining30%of the patients. The number of patients with academic qualification below primary school is 16, the number of patients with middle high school education is 11 and the number of patients with high school education and above is 13. Slipping is the cause of hip fracture that accounted for the most in patients, followed by outing activities, whereas least patients with hip fractures was caused by falling in nursing home. There were 29 patients’ whoused crutches or walking aids and this number was more than that of those who required the devices. After the MFS and FES analyses, the results (scores of MFS and FES) showed that the risk before the fall was lower. In contrast, the risk of fracture and post-surgery after the fall was greatly increased. Conclusion: The elderly patients with hip fractures were found to have increased risk of falling and thus, these patients require good care.

scholarly journals Factors which influence postoperative mortality after hip fracture

2006 ◽  
Vol 63 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Branko Ristic ◽  
Dragana Ristic-Ignjatovic ◽  
Biljana Milicic ◽  
Zdravko Obradovic
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Health Assessment ◽  
Postoperative Mortality ◽  
The Elderly ◽  
Physical And Mental Health ◽  
Mental Health Assessment ◽  
A Prospective Study ◽  
Type Of Fracture

Background/Aim. One of the most significant predictors of mortality after hip fractures is cognitive impairment (dementia). The aim of this study was to report the results of a prospective study of the influence of some factors on sixmonth mortality in elderly patients with hip fractures. Method. The elderly patients with hip fracture were assessed on admission to the hospital using the measures of cognitive function, the mobility before the fracture, and physical comorbidity, the type of fracture and the place of the injury. Six months later, we checked how many of them were still alive. Results. We performed univariate and multivariate analyses in 132 patients and found that the most significant predictors of six-month mortality were dementia, comorbidity, and prefacture mobility. Conclusions. A comprehensive physical and mental health assessment of an elderly patient after hip fracture could predict mortality. A good examination of cognitive functioning could be very useful in choosing the optimal treatment for this type of patients.

scholarly journals The impact of direct oral anti-coagulants on hip fracture management : a systematic review and meta-analysis

2021 ◽  
Vol 87 (2) ◽  
pp. 321-326
Author(s):  
Samuel Holmes ◽  
Sarmad Bahnam
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Mortality Risk ◽  
Meta Analysis ◽  
The Elderly ◽  
Operative Management ◽  
Control Group ◽  
Independent Analysis ◽  
Fracture Management ◽  
The Impact

Hip fractures are a common presentation in the elderly, a group who commonly have co-morbidities requiring the use of anticoagulants. Recently, direct oral anti-coagulants (DOAC) have become a popular method of anticoagulating patients. The primary aim of this review is to determine if the use of DOAC in elderly patients with hip fractures results in delays to theatre and/or an increased mortality risk. Major databases including Pubmed, MEDLINE and Embase were searched for relevant studies and the included studies reference lists were screened for further studies. A total of 6 studies were included in meta-analysis which was undertaken using RevMan software with 95% confidence interval (CI). Compared to control groups, patients who were anticoagulated with DOAC and required operative management of a hip fracture experienced a statistically significant delay to treatment. However independent analysis showed these patients did not experience an increased mortality risk when compared to the control group. While data is limited, treating clinicians should be comforted by these findings as operative manage- ment can be safely delayed to reduce the risk of intraoperative bleeding.

scholarly journals Outcome of nonoperative treatment for hip fractures in elderly patients: A systematic review of recent literature

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902093684
Author(s):  
Seung-Ju Kim ◽  
Hyun-Soo Park ◽  
Dong-Woo Lee
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Health Care Providers ◽  
Hip Fractures ◽  
Fragility Fractures ◽  
Nonoperative Treatment ◽  
Cochrane Library ◽  
Care Providers ◽  
Nonsurgical Management ◽  
Tract Infections

Many studies have shown that surgical management still leads to the best outcomes in elderly patients with hip fractures, with some studies showing non-inferiority of nonsurgical management as compared to surgery in fragility fractures. Evidence-based guidelines on whether to operate on these patients are lacking. A systematic literature search was conducted regarding outcomes of nonoperatively treated hip fractures in elderly patients with various comorbidities. A structured literature review of multiple databases (PubMed, Web of Science, EMBASE, and Cochrane library) referenced articles from 2000 to 2020. A total of 596 patients from 11 published studies were identified. Mean age was 83.3 years. Overall 328 (69.7%) complications occurred in 470 patients with nonsurgical treatment. Pneumonia and urinary tract infections were the most common complications which occurred in 53 (16.1%) and 46 (14.0%) patients, respectively. Hip fracture patients who were treated nonoperatively had a higher in-hospital (17.1% vs. 4.4%; p < 0.001), 30-day (31.4% vs. 10.2%; p < 0.001), and 1-year (48.5% vs. 19.9%; p < 0.001) mortality compared to a matched group of operatively treated patients ( n = 1464). Of the 110 patients whose reported cause of death was nonoperative care, 44 (40%) was due to pneumonia. Patients with nonoperative treatment following hip fracture were associated with substantially higher complication and mortality compared with patients who were treated operatively. Our study will help health-care providers and caregivers to enable more informed decision-making for families and patients confronted with a hip fracture.

scholarly journals Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lili Yu ◽  
Yanbin Zhu ◽  
Wei Chen ◽  
Hui Bu ◽  
Yingze Zhang
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Individual Risk ◽  
Factors Associated ◽  
Postoperative Stroke

Abstract Objectives Stroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures. Methods This was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke. Results During the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke. Conclusions Although most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind.

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