Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment

Folbert, Ellis; Hegeman, J.H.; Gierveld, R.; Netten, Jaap J. van; Velde, Detlef van der; Duis, H. J. ten; Slaets, Joris P. J.

doi:10.1007/s00402-017-2646-6

Cited by 92 publications

(71 citation statements)

References 21 publications

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“…The yearly incidences of pneumonia or UTIs in our study are lower compared to previous studies (with exception of UTI in one study (8) ), evaluating the risk after hip fracture surgery. (8)(9)(10)(11) However, these studies have several limitations; including only descriptive analysis and small study populations, (8)(9)(10)(11) measuring outcome as patient-reported, (11) or restricted to patients treated at a single institution or a selected university hospital. (8,9,11) We extended the knowledge by including community-based infections, evaluating trends over time, and considered death as competing risk to minimize potential bias.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

“…About 9% to 11% of hip fracture patients have been reported to develop hospital‐acquired pneumonia and 4% to 17.9% to develop urinary tract infection, within a varying follow‐up time window spanning from during admission to 6 months of follow‐up. Pneumonia is a leading cause of death among hip fracture patients, and is associated with an excess mortality risk among hip fracture patients .…”

Section: Introductionmentioning

confidence: 99%

“…(7) Although 1-year mortality decreased by 40% from 1980 through 2014, (5) despite an increase in the proportion of patients with severe comorbidity, hip fracture is still associated with a 10% mortality within 30 days and up to 30% within 1 year of surgery. (5,8) About 9% to 11% of hip fracture patients have been reported to develop hospital-acquired pneumonia and 4% to 17.9% to develop urinary tract infection, (8)(9)(10)(11) within a varying follow-up time window spanning from during admission to 6 months of follow-up. Pneumonia is a leading cause of death among hip fracture patients, (12,13) and is associated with an excess mortality risk among hip fracture patients.…”

Section: Introductionmentioning

confidence: 99%

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Increasing Risk of Hospital-Treated Infections and Community-Based Antibiotic Use After Hip Fracture Surgery: A Nationwide Study 2005–2016

Kjørholt

Johnsen

Kristensen

et al. 2018

Journal of Bone and Mineral Research

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We aimed to examine trends in the incidence of treated infections following hip fracture surgery in Denmark from 2005 to 2016. We conducted a nationwide cohort study using individual‐level linked data from Danish population‐based registries. We calculated cumulative incidence considering death as competing risk and, based on the pseudo‐observation method, risk ratios (RRs) with 95% confidence interval (CI) using the period 2005–2006 as a reference. RRs were adjusted for age, sex, and comorbidity. A total of 74,771 patients aged 65 years or older with first‐time hip fracture surgery were included. The risk of postoperative (at 15, 30, 90, and 365 days) infections increased during 2005–2016. The 30‐day cumulative incidence of all hospital‐treated infections increased from 10.8% (95% CI, 10.2% to 11.3%) in 2005–2006 to 14.3% (95% CI, 13.7% to 15.0%) in 2015–2016 (adjusted RR 1.32; 95% CI, 1.23 to 1.42). Adjusted RR for 30‐day hospital‐treated pneumonia was 1.70 (95% CI, 1.49 to 1.92). The 30‐day cumulative incidence of redeeming community‐based antibiotic prescriptions increased from 17.5% (95% CI, 16.8% to 18.2%) in 2005–2006 to 27.1% (95% CI, 26.3% to 27.9%) in 2015–2016 (adjusted RR 1.54; 95% CI, 1.47 to 1.62). The largest increase was observed for broad‐spectrum antibiotic use (adjusted RR 1.79; 95% CI, 1.68 to 1.90). During 2005–2016, risk of infections was substantially higher in hip fracture patients than in the general population. The risk of hospital‐treated pneumonia and antibiotic prescriptions increased more over time among hip fracture patients. We found increased risks of postoperative treated infections following hip fracture surgery during the 12‐year study period, which could not entirely be explained by similar infection trends in the general population. Given the high mortality following infections in the elderly, further research is needed to identify patients at increased risk to target preventive treatment and potentially reduce complications and mortality in hip fracture patients. © 2018 American Society for Bone and Mineral Research.

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Section: Comparison With Previous Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increasing Risk of Hospital-Treated Infections and Community-Based Antibiotic Use After Hip Fracture Surgery: A Nationwide Study 2005–2016

Kjørholt

Johnsen

Kristensen

et al. 2018

Journal of Bone and Mineral Research

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“…When these are recognised and tackled in an early admission stage, preventive multidisciplinary and nursing interventions may reduce adverse frailty outcomes (i.e. mortality) (Folbert et al, 2017;Pepersack, 2008). Screening tools may facilitate detecting frail patients, perhaps even better than quick clinical bedside observations (Hii, Lainchbury, & Bridgman, 2015), and may improve awareness on frailty among health professionals (Ament, 2014).…”

Section: Introductionmentioning

confidence: 99%

Frailty screening in hospitalised older adults: How does the brief Dutch National Safety Management Program perform compared to a more extensive approach?

Warnier

Rossum

Kuijk

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To examine the predictive properties of the brief Dutch National Safety Management Program for the screening of frail hospitalised older patients (VMS) and to compare these with the more extensive Maastricht Frailty Screening Tool for Hospitalised Patients (MFST‐HP). Background Screening of older patients during admission may help to detect frailty and underlying geriatric conditions. The VMS screening assesses patients on four domains (i.e. functional decline, delirium risk, fall risk and nutrition). The 15‐item MFST‐HP assesses patients on three domains of frailty (physical, social and psychological). Design Retrospective cohort study. Methods Data of 2,573 hospitalised patients (70+) admitted in 2013 were included, and relative risks, sensitivity and specificity and area under the receiver operating characteristic (AUC) curve of the two tools were calculated for discharge destination, readmissions and mortality. The data were derived from the patients nursing files. A STARD checklist was completed. Results Different proportions of frail patients were identified by means of both tools: 1,369 (53.2%) based on the VMS and 414 (16.1%) based on the MFST‐HP. The specificity was low for the VMS, and the sensitivity was low for the MFST‐HP. The overall AUC for the VMS varied from 0.50 to 0.76 and from 0.49 to 0.69 for the MFST‐HP. Conclusion The predictive properties of the VMS and the more extended MFST‐HP on the screening of frailty among older hospitalised patients are poor to moderate and not very promising. Relevance to clinical practice The VMS labels a high proportion of older patients as potentially frail, while the MFST‐HP labels over 80% as nonfrail. An extended tool did not increase the predictive ability of the VMS. However, information derived from the individual items of the screening tools may help nurses in daily practice to intervene on potential geriatric risks such as delirium risk or fall risk.

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“…Geriatricians will play a key role in enhancing care for older persons with hip fractures (37)(38)(39)(40), trauma (41,42), delirium, utilizing Delirium Intensive Care Units and other techniques (43)(44)(45)(46), and stroke patients (47,48). Working with dietitians they will have a specific role on preventing and treating undernutrition and cachexia in the hospital setting (49)(50)(51)(52)(53).…”

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confidence: 99%

Geriatrics in the 21st century

Vellas

Morley

2018

The Journal of nutrition, health and aging

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Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment

Cited by 92 publications

References 21 publications

Increasing Risk of Hospital-Treated Infections and Community-Based Antibiotic Use After Hip Fracture Surgery: A Nationwide Study 2005–2016

Increasing Risk of Hospital-Treated Infections and Community-Based Antibiotic Use After Hip Fracture Surgery: A Nationwide Study 2005–2016

Frailty screening in hospitalised older adults: How does the brief Dutch National Safety Management Program perform compared to a more extensive approach?

Geriatrics in the 21st century

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