Long-term outcome collection after hip fracture in Ireland: a systematic review of traditional and grey literature

Walsh, Mary E.; Cunningham, Caitríona; Brent, Louise; Savin, Bibiana; Fitzgerald, Michelle; Blake, Catherine

doi:10.1007/s00198-023-06713-x

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…This study showed that 20.5% of patients died within 1 year of sustaining a hip fracture. This is lower than the recently reported systematic review and meta-analysis of Irish research, which showed a 1-year mortality of 24.2% and is also lower than the reported European mean 1-year mortality of 23.2% [ 11 , 13 ].…”

Section: Discussioncontrasting

confidence: 65%

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1 year mortality after hip fracture in an Irish urban trauma centre

Ferris

Merron

Coughlan

2023

BMC Musculoskelet Disord

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Background Hip fracture accounts for a considerable burden of disease in older adults, yet there is a paucity of data pertaining to longer-term outcomes in the Irish Hip Fracture population. Understanding the factors that influence longer-term survival would allow care pathways to be refined to optimise patient outcomes. In Ireland, there is no linkage to death registration at a national or regional level, nor are longer-term outcomes captured by the Irish Hip Fracture Database. This study aimed to quantify 1-year mortality in an Irish hip fracture cohort and identify factors that influence survival at 1 year. Methods A retrospective review of hip fracture cases in an Irish urban trauma centre over a 5-year period was conducted. Mortality status was obtained via the Inpatient Management System and correlated with the Irish Death Events Register. A range of routinely collected patient and care process variables were analysed using logistic regression. Results A total of 833 patients were included. Within 1 year of sustaining a hip fracture, 20.5% (171/833) had died. On multivariate analysis, female gender (OR 0.36, p < 0.001, 95% CI 0.23–0.57), independent mobility pre-fracture (OR 0.24, p < 0.001, 95% CI 0.14–0.41) and early mobilisation on the day of or after surgery (OR 0.48, p < 0.001, 95% CI 0.30–0.77) reduced the likelihood of dying within 1 year (AUC 0.78). Conclusion Of the variables examined, early postoperative mobilisation was the only modifiable factor identified that conferred a longer-term survival benefit. This underscores the importance of adhering to international best practice standards for early postoperative mobilisation.

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Section: Discussioncontrasting

confidence: 65%

“…In Ireland, national data pertaining to 1-year survival is not currently captured by the Irish Hip Fracture Database. However, a systematic review and meta-analysis of Irish literature reported a 1-year mortality of 24.2% [ 13 ].…”

Section: National and International Landscapementioning

confidence: 99%

1 year mortality after hip fracture in an Irish urban trauma centre

Ferris

Merron

Coughlan

2023

BMC Musculoskelet Disord

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“… 25 The 1-year mortality rate after weight-bearing bone fractures is upto 24.2%. 26 The mortality rate after osteoporotic fractures is higher in patients with PBC than in those without PBC. 3 , 10 This may be explained by chronic hepatic inflammation, high disease burden, and other comorbidities observed in patients with PBC, which interfere with the wound healing process and increase the risk of complications.…”

Section: Discussionmentioning

confidence: 97%

Increased risk of fragility fractures in patients with primary biliary cholangitis

Lim,

Kim,

Kim

et al. 2024

JBMR Plus

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Large-scale studies on the risk of fragility fractures in patients with primary biliary cholangitis (PBC) are limited due to low incidence. We aimed to investigate whether PBC is associated with fragility fractures using real-world nationwide data. The Korean National Health Insurance Service claims data from 2007 to 2020 were analyzed in this population-based cohort study. Patients with PBC (n = 4951) were matched with controls (n = 19 793) using a 1:4 ratio based on age, sex, and follow-up duration. The primary outcome was fragility fracture, which comprised fractures of the vertebra, hip, distal radius, and proximal humerus. The incidence rates (IRs) and hazard ratios (HRs) were determined to assess the impact of PBC on fragility fractures. During the median follow-up period of 5.37 years, 524 patients in the PBC group had fragility fractures (IR, 18.59/1000 person-years [PYs]). After adjusting for covariates, PBC increased the risk of fragility fractures by 1.63-fold (95% confidence interval, 1.20–2.22; P = 0.002). The vertebra and hip were particularly susceptible to fracture in patients with PBC, with adjusted HRs of 1.77 and 2.23, respectively. In the subgroup analysis, the risk of fragility fracture was 2.53-fold higher in men and 1.59-fold higher in women with PBC than that in the respective matched control groups. Considering the morbidity and mortality related to fragility fractures, increasing awareness of fragility fracture risk and implementing appropriate preventive measures in patients with PBC are imperative.

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“…Potential confounders included age, sex, body mass index (Armstrong et al., 2011), length of hospital stay (Lambe et al., 2022), prehospital frailty level (Soukkio et al., 2018), femoral fracture site (Vrignaud et al., 2018), comorbidities (Zhu et al., 2022), walkability (Handoll et al., 2021), and residence, including home, a nursing home, or another hospital (Walsh et al., 2023). For this study, the outcome was the need for ADL assistance at discharge, and the predictor was the physical activity (Amaral Gomes et al., 2021) at the time of rehabilitation admission.…”

Section: Methodsmentioning

confidence: 99%

Relationship between independence in activities of daily living at discharge and physical activity at admission of older postoperative hip fracture rehabilitation inpatients: A retrospective case‐control study

Shimizu,

Kanai,

Asakawa

2024

Physiotherapy Res Intl

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Background and PurposeHip fractures are associated with a reduction in activities of daily living (ADL) and require long‐term care. The physical activity of patients with hip fractures is temporarily impaired immediately after surgery, causing difficulty in the measurement of physical activities at the time of rehabilitation admission. This study examined the relationship between ADL at discharge and light‐ and moderate‐intensity physical activity at the time of rehabilitation admission by determining a cut‐off value predicting ADL independence.MethodsThis retrospective case control study analyzed 43 postoperative hip fracture patients aged ≥65 years admitting into inpatient rehabilitation. ADL at discharge was assessed using the Functional Independent Measure motor items (FIM‐m). The duration of physical activity at the time of rehabilitation admission was measured using an activity tracker equipped with an accelerometer. Prehospital frailty was evaluated using Clinical Frailty Scale. The relationship between these variables was examined using Spearman's product‐moment correlation coefficient. Differences in physical activity between patients requiring and not requiring assistance with ADLs were examined using the analysis of covariance. A receiver operating characteristic curve of the need for ADL assistance at discharge was constructed from the duration of physical activity.ResultsThe duration of physical activity at the time of rehabilitation admission was related to FIM‐m at discharge. The cut‐off value of the duration of physical activity for predicting the need for ADL assistance at discharge was 135 s, with a sensitivity of 83.3% and specificity of 68.4% (area under the curve: 0.76).DiscussionThe duration of physical activity at the time of rehabilitation admission may be a factor that can quantitatively predict the risk of requiring assistance with ADLs at discharge in older hip fracture patients. The duration of light‐and‐moderate intensity physical activity may be a component of multidisciplinary inpatient rehabilitation to improve patients' ADL.

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Long-term outcome collection after hip fracture in Ireland: a systematic review of traditional and grey literature

Cited by 6 publications

References 38 publications

1 year mortality after hip fracture in an Irish urban trauma centre

1 year mortality after hip fracture in an Irish urban trauma centre

Increased risk of fragility fractures in patients with primary biliary cholangitis

Relationship between independence in activities of daily living at discharge and physical activity at admission of older postoperative hip fracture rehabilitation inpatients: A retrospective case‐control study

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