Spanish National Hip Fracture Registry (SNHFR): a description of its objectives, methodology and implementation

Sáez-López, Pilar; González-Montalvo, Juan Ignacio; Ojeda-Thies, Cristina; Mora-Fernández, Jesús; Muñoz-Pascual, Angélica; Cancio, J.; Tarazona, F J; Pareja, Teresa Fernández; Gómez-Campelo, Paloma; Montero-Fernández, Nuria; Alarcón, T.; Mesa-Lampre, P; Larrainzar-Gar, R; Duaso, Enric; Gil-Garay, E.; Díez-Pérez, A; Prieto-Alhambra, D; Queipo-Matas, R; Otero-Puime, Ángel

doi:10.1016/j.regg.2017.12.001

Cited by 33 publications

(16 citation statements)

References 13 publications

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“…It represents 71% of all regions nationally. Hospitals participate voluntarily, and its structure and operation has previously been described [2]. Data collection is performed following the Spanish translation of the Minimum Common Dataset (MCD) proposed by the Fragility Fracture Network (FFN), which shares three important features: It is concise, it covers the key elements that define the casemix, and it is compatible with existing audit databases.…”

Section: Methodsmentioning

confidence: 99%

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Usefulness of a national hip fracture registry to evaluate the profile of patients in whom antiosteoporotic treatment is prescribed following hospital discharge

et al. 2020

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This study was carried out to describe the profile of prescription of antiosteoporotic treatment at discharge after a hip fracture in the Spanish National Hip Fracture Registry. Prescription rates among hospitals ranged from 0 to 94% of patients discharged. The prescription rate was higher among patients with better cognitive and functional baseline status. Purpose National hip fracture registries are useful for assessing current care processes. The goals of this study were as follows: first, to know the rate of antiosteoporotic prescription at discharge among hip fracture patients in hospitals participating in the Spanish National Hip Fracture Registry (RNFC); second, to compare the differences between treated and non-treated patients; third, to analyze patients' characteristics associated with antiosteoporotic prescription at discharge; and fourth, to evaluate whether there were differences in the profile of patients discharged from hospitals with high and low prescription rates. Method Patients discharged after a fragility hip fracture in 2017 and participating in the RNFC were included. Demographic variables, cognitive and functional status, prefracture osteoporosis treatment, fracture type, anesthetic risk, hospital volume, and antiosteoporotic prescription at discharge were analyzed. Given that patients were clustered within hospitals, intraclass correlation was calculated and generalized estimating equations were fitted. Results A total of 6701 patients from 54 hospitals were included. Antiosteoporotic prescription at discharge was prescribed to 36.5% (CI95% 35.8-37.2%), with a wide inter-hospital variability (range 0-94%). The intraclass correlation due of clustering of patients within hospitals was 47.9%. Antiosteoporotic prescription was more likely in patients who were younger, lived at home, previously treated for osteoporosis, had better baseline functional and cognitive status, lower anesthetic risk, and were discharged from high-volume hospitals, all with p < 0.001. The general profile of patients discharged from hospitals with high and low rate of prescription was similar. Conclusions There is a wide variability between hospitals regarding antiosteoporotic prescription after hip fracture. This is more likely to be initiated in patients with better clinical, functional, and mental status and in those discharged from hospitals with larger volumes of patients. These results offer insights regarding the selection of patients receiving secondary prevention and raises questions on who and how many should be treated.

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Section: Methodsmentioning

confidence: 99%

“…It includes patients aged 75 years and above admitted for a fragility hip fracture. It includes the audit during acute hospitalization and a 30-day follow-up [2].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a national hip fracture registry to evaluate the profile of patients in whom antiosteoporotic treatment is prescribed following hospital discharge

et al. 2020

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“…Initiated by interested clinicians throughout Spain, the Spanish Hip Fracture Registry (RNFC) is a multicentre, observational, prospective audit including the variables proposed in the FFN MCD endorsed by over 20 regional and national scientific societies, as well as the FFN. It includes all patients 75 years or older admitted for hip fractures in any of the participating centers, which consent their inclusion, followed up for 30 days [20]. The pilot phase started in January 2017 with 10 hospitals, increasing to over 60 hospitals at the current moment (List of participating investigators of the Spanish RNFC, Supplementary Material).…”

Section: Spanish Hip Fracture Registry (Rnfc)mentioning

confidence: 99%

Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries

Ojeda-Thies

Sáez-López

Currie³

et al. 2019

Osteoporos Int

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“…Eighty-six percent of these fractures occur in patients aged 65 years or older, and 1 out of every 3 women, plus 1 out of every 12 men, will break their hip over the course of their lifetime [2]. Every year, around 300,000 people in the United States [3] and 45,000 in Spain [4] have a hip fracture. By 2050, there are expected to be 6 million cases a year worldwide [5].…”

Section: Introductionmentioning

confidence: 99%

Outcomes Evaluation after Application of Multidisciplinary Protocol of Shared Hospital Care in Patients Aged 65 Years and Older and Operated for Hip Fracture

Marín¹,

Martínez²,

Ripoll³

et al. 2020

Preprint

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Purpose: In geriatric patients, hip fracture is considered the greatest complication of osteoporosis in terms of morbidity, mortality, and cost. The aim of this study is to assess the effects of a multidisciplinary shared care protocol (trauma services, internal medicine, emergencies, anesthesia, nursing, hematology, pharmacy, rehabilitation, home hospitalization unit, and social services) on hospital stay and in-hospital mortality in inpatients aged 65 years or older and operated for hip fracture.Methods: Retrospective cohort study between January 2011 and December 2017. The unexposed group was made up of patients who did not receive care according to the multidisciplinary protocol, while the exposed group did. We excluded patients with polytrauma, conservative treatment, bilateral hip fracture, pathological fracture, or previous fracture already included in the series. Variables analyzed were demographic data, medical comorbidities, Charlson index, hemoglobin levels, hematocrit and blood transfusion, antiplatelet drugs, length of surgical delay, length of hospital stay, in-hospital mortality, and a composite risk outcome considering in-hospital mortality and/or hospital stay of more than 10 days. We fit a multivariable logistic regression model to calculate the odds ratio (OR) of experiencing outcomes.Results: The cohort included 681 patients: 310 were unexposed and 371, exposed. Compared to the unexposed group, patients receiving protocolized multidisciplinary care showed significantly lower in-hospital mortality (3.5% versus 7.7%; p = 0.015) and were less likely to have a hospital stay of more than 10 (16.4% versus 24.2%; p = 0.012). Mean length of hospital stay was 0.7 fewer days in the exposed group. Multivariable analysis showed the composite risk outcome was 51% lower in the exposed group, after adjusting for age, sex, heart failure, days to surgery, blood transfusion after surgery, and postoperative hemoglobin levels.Conclusion: Implementing the multidisciplinary shared care protocol halved the risk of in-hospital mortality and/or a hospital admission of more than 10 days in patients over 65 years with proximal femur fracture. It also reduced mean length of hospital stay.

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Spanish National Hip Fracture Registry (SNHFR): a description of its objectives, methodology and implementation

Cited by 33 publications

References 13 publications

Usefulness of a national hip fracture registry to evaluate the profile of patients in whom antiosteoporotic treatment is prescribed following hospital discharge

Usefulness of a national hip fracture registry to evaluate the profile of patients in whom antiosteoporotic treatment is prescribed following hospital discharge

Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries

Outcomes Evaluation after Application of Multidisciplinary Protocol of Shared Hospital Care in Patients Aged 65 Years and Older and Operated for Hip Fracture

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