Registro de fracturas de cadera multicéntrico de unidades de Ortogeriatría de la Comunidad Autónoma de Madrid / Multi-centre register study of hip fractures in Orthogeriatric Units in the Community of Madrid (Spain)

Objetivos: Describir las características de pacientes con fractura de cadera (FC) ingresados desde enero de 2015 a diciembre de 2016 en ocho unidades de Ortogeriatría de hospitales públicos de la Comunidad Autónoma de Madrid. Material y métodos: Estudio descriptivo, prospectivo y multicéntrico. Se constituyó en 2014 un grupo de trabajo en FC; se invitó a la participación a todos los hospitales con algún tipo de asistencia conjunta entre Traumatología y Geriatría, participando los geriatras responsables de la unidad de Ortogeriatría de ocho hospitales. Se consensuó una base de datos con las variables con impacto en resultados de salud (sociodemográficas, clínicas y evolutivas durante el proceso asistencial). Resultados: Se incluyeron 3.995 pacientes; el 76,3% eran mujeres, y la edad media fue de 85,3años (rango 58-108años). El 67% fueron clasificados según el Physical Status Classification System de la American Society of Anesthesiologist (ASA) como III-IV. Se intervinieron el 96,7% de los pacientes (el 35,9% de ellos en las primeras 48h del ingreso, con una mediana de tiempo de retraso quirúrgico de 3días). La principal causa del retraso quirúrgico fueron los problemas logísticos en el 43,5% de los casos. La estancia hospitalaria media fue de 11,2días. Precisaron trasfusión el 53,1%. La mortalidad durante el ingreso fue del 5,3%. Conclusiones: Los registros de FC son un elemento imprescindible para conocer el proceso de atención a estos pacientes y poder aprender y mejorar la calidad asistencial. Nuestros resultados se adecúan a los de otros registros internacionales. Se debe mejorar el tiempo de espera prequirúrgica, consiguiendo intervenir en las primeras 48h a todos los pacientes sin datos de inestabilidad clínica. Igualmente se precisa mayor dotación de recursos de recuperación funcional y mayor uniformidad de estos

Objective: To describe the characteristics of patients with hip fractures admitted over a period of two years (from January 2015 to December 2016) in eight Orthogeriatric Units in public hospitals of the Community of Madrid. Material and method: This is a descriptive, prospective and multi-centre study. In 2014, all hospitals in Madrid providing joint Geriatric and Traumatology assistance were invited to a recently created orthogeriatric work group. Geriatricians in charge of the Orthogeriatric Unit from eight hospitals took part in this study. The participants established a database including all variables that influenced health outcomes (socio-demographic and clinical variables). Results: The study includes 3,995 patients, with a mean age of 85.3years (range: 58-108years old). Two-thirds of them were ASA (American Society Physical Status Classification System) III-IV. Almost all (96.7%) of the patients underwent a surgical operation, and 35.9% of them were operated during the first 48hours. The delay was mainly due to logistic problems (43.5%). The mean hospital stay was 11.2days. Just over half (53.1%) of the patients required a blood transfusion. In-hospital mortality was 5.3%. Discussion: Hip fracture registries are essential tools to monitor the healthcare process of these patients, as well as to improve the quality of care. Our results are similar to other records. It would be necessary to improve pre-operative time, which must be less than 48hours in patients without clinical instability. We also need more resources for functional recovery and more uniformity

[Multi-centre register study of hip fractures in Orthogeriatric Units in the Community of Madrid (Spain)]. / Registro de fracturas de cadera multicéntrico de unidades de Ortogeriatría de la Comunidad Autónoma de Madrid.

OBJECTIVE: To describe the characteristics of patients with hip fractures admitted over a period of two years (from January 2015 to December 2016) in eight Orthogeriatric Units in public hospitals of the Community of Madrid. MATERIAL AND METHOD: This is a descriptive, prospective and multi-centre study. In 2014, all hospitals in Madrid providing joint Geriatric and Traumatology assistance were invited to a recently created orthogeriatric work group. Geriatricians in charge of the Orthogeriatric Unit from eight hospitals took part in this study. The participants established a database including all variables that influenced health outcomes (socio-demographic and clinical variables). RESULTS: The study includes 3,995 patients, with a mean age of 85.3years (range: 58-108years old). Two-thirds of them were ASA (American Society Physical Status Classification System) III-IV. Almost all (96.7%) of the patients underwent a surgical operation, and 35.9% of them were operated during the first 48hours. The delay was mainly due to logistic problems (43.5%). The mean hospital stay was 11.2days. Just over half (53.1%) of the patients required a blood transfusion. In-hospital mortality was 5.3%. DISCUSSION: Hip fracture registries are essential tools to monitor the healthcare process of these patients, as well as to improve the quality of care. Our results are similar to other records. It would be necessary to improve pre-operative time, which must be less than 48hours in patients without clinical instability. We also need more resources for functional recovery and more uniformity.