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

Ojeda-Thies, Cristina; Sáez-López, Pilar; Currie, Colin; Tarazona-Santalbina, F J; Alarcón, T.; Muñoz-Pascual, Angélica; Pareja, Teresa Fernández; Gómez-Campelo, Paloma; Montero-Fernández, Nuria; Mora-Fernández, Jesús; Larraínzar-Garijo, Ricardo; Gil-Garay, E.; Etxebarría-Foronda, I.; Caeiro, J.R.; Díez-Pérez, A; Prieto‐Alhambra, Daniel; Navarro-Castellanos, Laura; Otero-Puime, Ángel; González-Montalvo, Juan Ignacio

doi:10.1007/s00198-019-04939-2

Cited by 61 publications

(57 citation statements)

References 26 publications

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“…Our population showed slightly higher mean age and slightly lower 30-day mortality rate than other previously reported studies on hip fracture populations (26,27).…”

Section: Discussioncontrasting

confidence: 58%

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Casa¹,

Pablos‐Hernández²,

González‐Ramírez³

et al. 2020

Preprint

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Background The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to validate the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale analyzed in the Comprehensive Geriatric Assessment at admission as predictors of 30-day mortality after hip fracture surgery. Methods Prospective study including 899 hip fracture patients over 65. Bed-ridden, non- surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ2, and we performed binary logistic regression for risk assessment. P < 0.05 was considered statistically significant. Results We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR = 0.986 [0.975–0.996], p = 0.010), Katz Index (OR per point = 1.254 [1.089–1.444], p = 0.002), Lawton-Brody Index (OR = 0.885 [0.788–0.992], p = 0.037), and Physical Red Cross Scale (OR = 1.483 [1.094–2.011], p = 0.011) with the 30-day mortality of patients after hip fracture surgery. We also validate the Barthel Index inflection point (0–55) (ORBI(0−55) = 2.428 [1.379–4.275], p = 0.002) and Katz Index inflection point (A-B) (ORKI(A−B) = 0.493 [0.273–0.891], p = 0.019) for the assessment of the highest risked patients. Conclusions The geriatric scores would be useful multifunctional tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.

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“…Our population showed slightly higher mean age and slightly lower 30-day mortality rate than other previously reported studies on hip fracture populations (26,27).…”

Section: Discussioncontrasting

confidence: 58%

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Casa¹,

Pablos‐Hernández²,

González‐Ramírez³

et al. 2020

Preprint

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“…In fact, the mean age of patients with hip fracture in Spain is 86.7 years, twelve years higher than in our patients. 36 In conclusion, in our study population, COPD was not a risk factor for hip fracture within the next five years. However, studies with a longer follow-up period will be necessary to clarify any potential association.…”

mentioning

confidence: 48%

<p>Chronic Obstructive Pulmonary Disease and Incidence of Hip Fracture: A Nested Case–Control Study in the EpiChron Cohort</p>

Díez-Manglano¹,

Vidal²,

Barredo³

et al. 2020

COPD

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Purpose: To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture and identify other factors associated with hip fracture. Patients and Methods: Observational nested case-control study was conducted in Aragon, Spain in 2010. We included COPD patients aged >40 years, in the EpiChron cohort. Each COPD patient was matched for age, sex, and number of comorbidities with a control subject without COPD. Patients with an existing diagnosis of osteoporosis and those with hip fracture before 2011 were excluded. We collected baseline demographic, comorbidity, and pharmacological treatment data. During a 5-year follow-up period, we recorded the incidence of hip fracture. A logistic regression model was constructed to identify factors associated with hip fracture. Results: The study population consisted of 26,517 COPD patients and the same number of controls (median [interquartile range] age, 74 [17] years; women, 24.7%). Smoking and heart failure were more frequent in COPD patients, and obesity, hypertension, diabetes, dyslipidemia, stroke, arthritis, and visual or hearing impairment were less frequent (all p<0.001). Consumption of benzodiazepines (p=0.037), bronchodilators (p<0.001), and corticosteroids (p<0.001) was higher in the COPD group, while that of beta-blockers and thiazides was lower (both p<0.001). During follow-up, 898 (1.7%) patients experienced hip fracture, with no differences observed between COPD and control patients. Multivariate analysis revealed that independent of COPD status, age, female sex, chronic liver disease, heart failure, and benzodiazepine use were independently associated with a higher risk of hip fracture, and obesity with a lower risk. In COPD patients, use of inhaled anticholinergics was independently associated with hip fracture (OR, 1.390; 95% CI 1.134-1.702; p=0.001). Conclusion: COPD is not a risk factor for a hip fracture within 5 years. The association between the use of inhaled anticholinergics and risk of hip fracture warrants further study.

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“…The wide variability of antiosteoporotic prescription at discharge rates has also been described in the Danish Hip Fracture Registry (14-100%) [7], the Irish Hip Fracture Database (17-85%) [6], and the Australia and New Zealand Hip Fracture Registry (rates of 0-70% and 0-48% for Australia and New Zealand, respectively) [8]. There is also a large variability in other indicators such as length of stay [20].…”

Section: Prescription Rate and Variabilitymentioning

confidence: 94%

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

Cited by 61 publications

References 26 publications

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

<p>Chronic Obstructive Pulmonary Disease and Incidence of Hip Fracture: A Nested Case–Control Study in the EpiChron Cohort</p>

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

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