Early Operation on Patients with a Hip Fracture Improved the Ability to Return to Independent Living

Al-Ani, Amer N.; Samuelsson, Bodil; Tidermark, Jan; Norling, Ameli; Ekström, Wilhelmina; Cederholm, Tommy; Hedström, Margareta

doi:10.2106/jbjs.g.00890

Cited by 228 publications

(180 citation statements)

References 25 publications

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“…Sin embargo, también hay autores que ponen en duda tal aseveración 14,23,33,34 . Existe controversia por tanto acerca de si el retraso en realizar la cirugía en este tipo de fracturas genera más mortalidad, pero lo que sí parece claro es que una cirugía temprana está asociada a un menor número de complicaciones, mejores resultados funcionales, menor estancia hospitalaria y menos reingresos, lo cual indudablemente está asociado a un menor coste 14,35 . La mayoría de las guías de práctica clínica recomiendan que la intervención se realice dentro de las primeras 24-48 horas [36][37] , por lo que podemos considerar los tiempos de demora de nuestra muestra como superiores a lo deseable.…”

Section: Discussionunclassified

Mortalidad y costes asociados a la demora del tratamiento quirúrgico por fractura de cadera

Etxebarría-Foronda

Mar

Arrospide

et al. 2013

Rev. Esp. Salud Publica

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RESUMENFundamentos: La intervención quirúrgica en las fracturas de cadera suele demorarse varios días. Nuestro trabajo tiene dos objetivos. Estudiar la estancia preoperatoria de los pacientes ingresados por fractura de cadera en los hospitales vascos durante el año 2010 y medir su posible asociación con la mortalidad intrahospitalaria, y estimar el coste económico que supone la estancia preoperatoria.Métodos. Se realizó un estudio observacional analizando los siguientes datos del Conjunto Mínimo Básico de Datos (CMBD): hospital, edad, sexo, estancia preoperatoria, estado al alta, diagnósticos asociados y procedimiento quirúrgico. Además, se estudió el índice de comorbilidad de Charlson y se calculó el coste unitario de la estancia pre y postoperatoria mediante modelos de regresión múltiple.Resultados. Se analizó una muestra de 1.856 intervenciones. La estancia preoperatoria fue de 2,7 días y la postoperatoria de 9,7 días. El coste medio por ingreso fue de 12.552,12 euros. El coste medio de la estancia preoperatoria fue de 1295,5 euros. La mortalidad fue del 5%.Conclusiones. La estancia preoperatoria no es un factor estadística-mente asociado con la mortalidad, aunque aumenta significativamente el coste total. No encontramos una asociación entre la demora quirúrgica y la mortalidad, aunque sí tiene una clara influencia en el coste total del proceso. La reducción del tiempo prequirúrgico permite ahorrar costes. Background: Hip fractures surgery is often delayed for several days. The present work has two objectives. The first one is to determine the preoperative hospital length of stay of patients with a hip fracture in our region and its possible correlation with an increase in mortality rate. Secondly we assessed the healthcare expenditure associated to this preoperative period.

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Section: Discussionunclassified

Mortalidad y costes asociados a la demora del tratamiento quirúrgico por fractura de cadera

Etxebarría-Foronda

Mar

Arrospide

et al. 2013

Rev. Esp. Salud Publica

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“…Some studies show time to surgical stabilization is an important determinant of outcome among patients with hip fractures [5,30,32,38,47]. It is possible that higher nurse staffing levels in a hospital also might expedite surgical stabilization of hip fracture.…”

Section: Independent Variablementioning

confidence: 99%

Do Higher Hospital-wide Nurse Staffing Levels Reduce In-hospital Mortality in Elderly Patients with Hip Fractures: A Pilot Study

Schilling

Goulet

Dougherty

2011

Clinical Orthopaedics &Amp; Related Research

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“…Many studies recommend performing surgery for patients with hip/femur fracture within the first 24 to 48 hours of admission [16,32,61,65,77,84]. Early surgery has been associated with reduced minor and major complications [2,54]. Early surgery also reduces the negative effects of immobility on the patients.…”

Section: Preoperative Assessment and Preparation For Surgerymentioning

confidence: 99%

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Bukata

Kates

O’Keefe

2011

Clinical Orthopaedics &Amp; Related Research

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Background Patients with impaired bone quality who suffer a fragility fracture face substantial challenges in both their short-and long-term care. In addition to poor bone quality, many of these patients have multiple medical comorbidities that alter their surgical risk and affect their ultimate functional recovery. Some medical issues can contribute to the altered bone quality and must be addressed to prevent future fractures. Questions/purposes This review summarizes the modifications in perioperative management and fracture fixation in patients with common fragility fractures who have impaired bone quality. It also summarizes the postoperative diagnosis and treatment of secondary causes of impaired bone quality in these patients. Methods We performed a PubMed search, and literature published after 2000 was prioritized, with the exception of benchmark clinical trial studies published before 2000. Results Patients with altered bone quality require rapid perioperative management of multiple medical comorbidities. Implant selection in patients with poor quality bone should permit early weightbearing, and constructs should maximize surface area contact with the remaining bone. Long-term diagnosis and treatment of other disease states contributing to poor bone quality (vitamin D deficiency/ insufficiency, hypothyroidism, hyperthyroidism, hyperparathyroidism, Cushing's disease, and hypogonadism) must occur to minimize the chances of future fractures. Conclusions Recognition of patients with impaired bone quality and proper treatment of their special needs in both the short and long term are essential for their best opportunity for maximal functional recovery and prevention of future fractures.

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Early Operation on Patients with a Hip Fracture Improved the Ability to Return to Independent Living

Abstract: Early compared with late operative treatment of patients with a hip fracture is associated with an improved ability to return to independent living, a reduced risk for the development of pressure ulcers, and a shortened hospital stay.

Cited by 228 publications

References 25 publications

Mortalidad y costes asociados a la demora del tratamiento quirúrgico por fractura de cadera

Mortalidad y costes asociados a la demora del tratamiento quirúrgico por fractura de cadera

Do Higher Hospital-wide Nurse Staffing Levels Reduce In-hospital Mortality in Elderly Patients with Hip Fractures: A Pilot Study

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

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