Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Vochteloo, Anne J H; Tuinebreijer, W.E.; Maier, Andrea B.; Nelissen, Rob G H H; Bloem, Rolf M.; Pilot, Peter

doi:10.1007/s00264-012-1526-5

Cited by 18 publications

(18 citation statements)

References 21 publications

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“…The DHP was developed using data of 310 hip fracture patients aged 50 years and older admitted to a 450-bed teaching hospital (Delft, the Netherlands) between January 2008 and December 2009 [7]. Patients with a fracture due to a high-energy trauma or with a pathological fracture, patients not living in their own home prior to admission, those treated conservatively and those that died during hospital stay were not included in this cohort.…”

Section: Patientsmentioning

confidence: 99%

“…Higher age, female gender, dementia, absence of a partner, and a more limited level of mobility are score items, each with a weighting factor based upon the beta coefficient in the multivariable regression analysis. The beta coefficients were rounded up and the regression coefficients associated with the questions were transformed into a simple score that could be summated up to obtain an aggregate score (Table 1) [7].…”

Section: Discharge Of Hip Fracture Patients Score (Dhp)mentioning

confidence: 99%

“…Recently, we described the Discharge of Hip fracture Patients score (DHP) [7]. This score predicts, on admission, the discharge location in patients living in their own home prior to admission for a hip fracture.…”

Section: Introductionmentioning

confidence: 99%

“…This score predicts, on admission, the discharge location in patients living in their own home prior to admission for a hip fracture. The DHP was designed on prospective data of a Dutch cohort of 310 patients aged 50 or more years admitted to a general teaching hospital in the western part of the Netherlands [7]. Risk factors for DAL were identified using multivariable regression analysis [7].…”

Section: Introductionmentioning

confidence: 99%

“…The DHP was designed on prospective data of a Dutch cohort of 310 patients aged 50 or more years admitted to a general teaching hospital in the western part of the Netherlands [7]. Risk factors for DAL were identified using multivariable regression analysis [7]. Higher age, female gender, dementia, absence of a partner and a limited level of mobility were found to be predictive.…”

Section: Introductionmentioning

confidence: 99%

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External validation of the discharge of hip fracture patients score

Vochteloo

Tuinebreijer

Maier

et al. 2013

International Orthopaedics (SICOT)

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Purpose This paper reports the external validation of a recently developed instrument, the Discharge of Hip fracture Patients score (DHP) that predicts discharge location on admission in patients living in their own home prior to hip fracture surgery. Methods The DHP (maximum score 100 points) was applied to 125 hip fracture patients aged 50 or more years admitted to an academic centre in the northern part of the Netherlands (Groningen cohort). The characteristics of this cohort, sensitivity, specificity and positive and negative predictive value (PPV, NPV) of the DHP for discharge to an alternative location (DAL) were calculated and compared with the original cohort of hip fracture patients from the western part of the Netherlands (Delft cohort). Scoring 30 points or higher indicated DAL. Results The Groningen cohort was younger compared to the Delft cohort, (mean age 75.4 vs. 78.5 years, P=0.005) but was more often classified ASA III/IV (46.4 % vs. 25.2 %, P< 0.001). Sensitivity of the DHP for DAL in the Groningen cohort was 75 % (vs. 83.8 %), specificity of 66.7 % (vs. 64.7 %) and a PPV of 86.3 % (vs. 79.2 %), compared to the Delft cohort. Conclusion External validation of the DHP was successful; it predicted discharge location of hip fracture patients accurately in another Dutch cohort, the sensitivity for DAL was somewhat lower but the PPV higher. Therefore, the DHP score is a useful valid and easily applied instrument for general hip fracture populations.

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Section: Patientsmentioning

confidence: 99%

Section: Discharge Of Hip Fracture Patients Score (Dhp)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

External validation of the discharge of hip fracture patients score

Vochteloo

Tuinebreijer

Maier

et al. 2013

International Orthopaedics (SICOT)

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Predictors of early mortality after hip fracture surgery

Khan

Hossain

Idbaïh

et al. 2013

International Orthopaedics (SICOT)

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Purpose The aim of this study was to examine causes and potential risk factors for 30-day mortality after hip fracture surgery (HFS) at a high-volume tertiary-care hospital. Methods We retrospectively reviewed 467 patients who underwent HFS at our institution. Multivariate analysis was undertaken to identify potential predictors of early mortality. Results The 30-day mortality rate was 7.5 % (35/467). The most common causes of death were pneumonia (37.1 %, 13/ 35), acute coronary syndrome (31.4 %, 11/35) and sepsis (14.3 %, 5/35). Surgery after 48 hours of admission had a significantly higher 30-day mortality rate (11 % versus 4 %, p =0.006). There was a significant difference in age (p =0.034), admission source (p <0.001), preoperative haemoglobin (p < 0.001), walking ability (p =0.004), number of comorbidities (p =0.004) and pre-existing dementia (p =0.01), cardiac disease (p <0.001), chronic obstructive pulmonary disorder (COPD) (p =0.036) and renal failure (p =0.007) between the 30-day mortality group and the rest of the cohort. Surgical delay greater than 48 hours, admission source and preexisting cardiac disease were identified as the strongest predictors of 30-day mortality. Conclusion Surgical delay is an important but avoidable determinant of early mortality after HFS. Respiratory and cardiac function needs to be optimised postoperatively with early intervention in patients with signs of cardiovascular compromise or infection.

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