Abstract
Background
Evidence-based practice supports the provision of integrated geriatric multidisciplinary care for older people with hip fractures.
Aims
To show that introduction of orthogeriatric services resulted in improved care and better patient outcomes.
Methods
We compared two audits: a 2001 audit of 103 patients over the age of 65 years with hip fracture and a 2006 audit on 98 admissions using the same parameters.
Results
Inpatient mortality dropped from 20% to 8%. Discharge to home increased from 8% to 18% and to nursing home fell from 25% to 21%. Prescription of perioperative antibiotics, DVT prophylaxis and osteoporosis medications improved. There were no significant differences in age or sex but there were significantly higher levels of disability in the 2001 group.
Conclusion
Following introduction of an orthogeriatric service, improvements in mortality and discharge destination occurred. This may have been influenced by higher proportions of disability among the 2001 cohort.
Similar content being viewed by others
References
Marottoli RA, Berkman LF, Cooney LM (1992) Decline in physical function following hip fracture. J Am Geriatr Soc 40:861–866
Zuckerman JD (1996) Hip fracture. N Engl J Med 334(23):1519–1525. doi:10.1056/NEJM199606063342307
Cameron ID, Handoll HH, Finnegan TP, Madhok R, Langhorne P (2001) Co-ordinated multidisciplinary approaches for inpatient rehabilitation of older patients with proximal femoral fractures. Cochrane Database Syst Rev (3):CD000106
Cameron I, Crotty M, Currie C, Finnegan T, Gillespie L, Gillespie W (2000) Geriatric rehabilitation following fractures in older people: a systematic review. Health Technol Assess 4(2):i–iv 1–111
Halbert J, Crotty M, Whitehead C, Cameron I, Kurrie S, Graham S, Finnegan T, Foleys A, Shanahan M (2007) Multi-disciplinary rehabilitation after hip fracture is associated with improved outcome: a systematic review. J Rehabil Med 39(7):507–512. doi:10.2340/16501977-0102
British Orthopaedic Association (2007) The care of patients with fragility fractures. British Orthopaedic Association, United Kingdom
Hommel A, Ulander K, Thorngren K-G (2003) Improvements in pain relief, handling time and pressure ulcers through internal audits of hip fracture patients. Scand J Caring Sci 17(1):78–83. doi:10.1046/j.1471-6712.2003.00212.x
The Scottish Hip Fracture Audit Report 2008. ISD Scotland Publications, NHS National Services Scotland, Edinburgh. http://www.shfa.scot.nhs.uk/
Prevention and Management of Hip Fracture in Older People Scottish Intercollegiate Guidelines Network (SIGN), Royal College of Physicians, Edinburgh, 2002. http://www.sign.ac.uk/guidelines/fulltext/56/index.html
Mater Misericordiae University Hospital Corporate Plan 2004–2006; Dublin, Ireland, 2004. http://www.mater.ie/publications/corporateplan/Corporate%20Plan%20October%20Document%20Final%20Draft%206th%20Oct.pdf
Keating JF, Grant A, Masson M, Scott NW, Forbes JF (2006) Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty: treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am 88(2):249–260. doi:10.2106/JBJS.E.00215
Gillespie WJ, Murray D, Gregg PJ, Warwick D (2000) Risks and benefits of prophylaxis against venous thromboembolism in orthopaedic surgery. J Bone Joint Surg Br 82(4):475–479
Gillespie WJ, Walenkamp G (2001) Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures. Cochrane Database Syst Rev (1):CD000244
Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population Health Service Executive, Ireland, 2008. http://www.hse.ie/eng/Publications/Older_People_and_Nursing_Homes/Strategy_to_Prevent_Falls_and_Fractures_in_Ireland%e2%80%99s_Ageing_Population__Full_report.pdf
Parker MJ, Currie CT, Mountain JA, Thorngren KG (1998) Standardised audit of hip fracture in Europe (SAHFE). Hip Int 8:10–15
Acknowledgments
We would like to acknowledge the input of Ms. M. Vartuli from the Information Management Services in the Mater Misericordiae University Hospital for providing length of stay data.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cogan, L., Martin, A.J., Kelly, L.A. et al. An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006. Ir J Med Sci 179, 51–55 (2010). https://doi.org/10.1007/s11845-009-0377-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-009-0377-6