Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement

Manach, Yannick Le; Collins, Gary S.; Bhandari, Mohit; Bessissow, Amal; Boddaert, Jacques; Khiami, F.; Chaudhry, Harman; Beer, Justin de; Riou, Bruno; Landais, Paul; Winemaker, Mitchell; Boudemaghe, Thierry; Devereaux, P. J.

doi:10.1001/jama.2015.10842

Cited by 173 publications

(120 citation statements)

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“…Additionally, patients with fractures were more likely to be discharged to a rehabilitation facility than patients with OA. Similarly, a recent article using the National French Hospital Discharge Database performed a matched comparison of THA in patients with either OA or femoral neck fracture [13]. Their findings were very similar to those of the current study: patients with fractures were older and had more medical comorbidities than those undergoing elective THA for OA, but even after matching, there were higher complication rates in the patients with fractures than those with OA.…”

Section: Discussionsupporting

confidence: 81%

“…However, prior studies comparing cohorts of patients with femoral neck fracture and patients with OA have been limited to primarily in-hospital analyses [13,17]. Finally, only THAs were analyzed, yet differences between hip arthroplasty cohorts that include patients receiving hemiarthroplasty for fracture would likely be more profound, because there is typically surgeon selection bias for performing hemiarthroplasty over THA in more infirm and more elderly patients with femoral neck fractures [2].…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have directly compared the outcomes after THA in patients with OA and patients with femoral neck fractures [1,13,14]. These studies have principally analyzed the in-hospital differences between these two groups of patients.…”

Section: Introductionmentioning

confidence: 99%

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Lane

Halsey

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Hip fractures are a major public health concern. For displaced femoral neck fractures, the needs for medical services during hospitalization and extending beyond hospital discharge after total hip arthroplasty (THA) may be different than the needs after THA performed for osteoarthritis (OA), yet these differences are largely uncharacterized, and the Medicare Severity Diagnosis-Related Groups system does not distinguish between THA performed for fracture and OA. Questions/purposes (1) What are the differences in inhospital and 30-day postoperative clinical outcomes for THA performed for femoral neck fracture versus OA? (2) Is a patient's fracture status, that is whether or not a patient has a femoral neck fracture, associated with differences in in-hospital and 30-day postoperative clinical outcomes after THA?Methods The National Surgical Quality Improvement Program (NSQIP) database, which contains outcomes for surgical patients up to 30 days after discharge, was used to identify patients undergoing THA for OA and femoral neck fracture. OA and fracture cohorts were matched one-to-one using propensity scores based on age, gender, American Society of Anesthesiologists grade, and medical comorbidities. Propensity scores represented the conditional probabilities for each patient having a femoral neck fracture based on their individual characteristics, excluding their actual fracture status. Outcomes of interest included operative time, length of stay (LOS), complications, transfusion, discharge destination, and readmission. There were 42,692 patients identified (41,739 OA; 953 femoral neck fractures) with 953 patients in each group for the matched analysis.One of the authors (JML) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: Amgen, Inc (Thousand Oaks, CA, USA) in the amount of less than USD 10,000; Eli Lilly and Company (Indianapolis, IN, USA) in the amount of less than USD 10,000; Graftys (Aix-en-Provence, France) in the amount of less than USD 10,000; Kuros Biosurgery AG (Zürich, Switzerland) in the amount of less than USD 10,000; Bone Therapeutics (Brussels, Belgium) in the amount of less than USD 10,000; and Merck & Co, Inc (Kenilworth, NJ, USA) in the amount of USD 100,001 to USD 1,000,000. One of the authors (DEP) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: Mako Surgical Corp (Davie, FL, USA) in the amount of less than USD 10,001 to USD 100,000; and Stryker Corporation (Kalamazoo, MI, USA) in the amount of less than USD 10,000. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research1 editors and board members are on file with the publication and can be viewed on request.Each ...

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Halsey

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Clinical Orthopaedics &Amp; Related Research

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“…In addition, the gradual increase in fees-for-services enhanced the coding quality [5]. The introduction of these systems enabled new epidemiological and/or economic studies [6][7][8][9] using these databases, with temporal follow-up of patients allowing tracing of their trajectory of care. This review investigated how the trajectory concept is defined, studied and what it achieves.…”

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confidence: 99%

Patient healthcare trajectory. An essential monitoring tool: a systematic review

Pinaire

Azé

Bringay

et al. 2017

Health Inf Sci Syst

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Background: Patient healthcare trajectory is a recent emergent topic in the literature, encompassing broad concepts. However, the rationale for studying patients' trajectories, and how this trajectory concept is defined remains a public health challenge. Our research was focused on patients' trajectories based on disease management and care, while also considering medico-economic aspects of the associated management. We illustrated this concept with an example: a myocardial infarction (MI) occurring in a patient's hospital trajectory of care. The patient follow-up was traced via the prospective payment system. We applied a semi-automatic text mining process to conduct a comprehensive review of patient healthcare trajectory studies. This review investigated how the concept of trajectory is defined, studied and what it achieves.Methods: We performed a PubMed search to identify reports that had been published in peer-reviewed journals between January 1, 2000 and October 31, 2015. Fourteen search questions were formulated to guide our review. A semi-automatic text mining process based on a semantic approach was performed to conduct a comprehensive review of patient healthcare trajectory studies. Text mining techniques were used to explore the corpus in a semantic perspective in order to answer non-a priori questions. Complementary review methods on a selected subset were used to answer a priori questions.Results: Among the 33,514 publications initially selected for analysis, only 70 relevant articles were semi-automatically extracted and thoroughly analysed. Oncology is particularly prevalent due to its already well-established processes of care. For the trajectory thema, 80% of articles were distributed in 11 clusters. These clusters contain distinct semantic information, for example health outcomes (29%), care process (26%) and administrative and financial aspects (16%). Conclusion:This literature review highlights the recent interest in the trajectory concept. The approach is also gradually being used to monitor trajectories of care for chronic diseases such as diabetes, organ failure or coronary artery and MI trajectory of care, to improve care and reduce costs. Patient trajectory is undoubtedly an essential approach to be further explored in order to improve healthcare monitoring.

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“…Although hip fracture surgery alone accounts for half of the in-hospital deaths that occur after orthopaedic surgery [8], it is not the only ''routine'' diagnosis that should prompt a conversation about end-of-life issues. For example, the inhospital risk of death in a patient with septic arthritis from Staphylococcus aureus, a common-enough problem, is in the range of 5% to 13% [1,17] comparable to or greater than the risk of mortality following hip fracture surgery, which has been estimated at 2% to 5% [2,8,19].…”

mentioning

confidence: 99%

Editorial: Do-Not-Resuscitate Orders and Advance Directives—Existential Issues for Orthopaedic Patients with Life-threatening Conditions

Leopold

2016

Clinical Orthopaedics &Amp; Related Research

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Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement

Abstract: In a large cohort of French patients, hip fracture surgery compared with elective THR was associated with a higher risk of in-hospital mortality after adjustment for age, sex, and measured comorbidities. Further studies are needed to define the causes for these differences.

Cited by 173 publications

References 30 publications

The Frank Stinchfield Award

The Frank Stinchfield Award

Patient healthcare trajectory. An essential monitoring tool: a systematic review

Editorial: Do-Not-Resuscitate Orders and Advance Directives—Existential Issues for Orthopaedic Patients with Life-threatening Conditions

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