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Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

Librero, Julian; Peiro, Salvador; Leutscher, Edith; Merlo, Juan LU ; Bernal-Delgado, Enrique; Ridao, Manuel; Martinez-Lizaga, Natalia and Sanfelix-Gimeno, Gabriel (2012) In BMC Health Services Research 12(15).
Abstract
Background: While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods: A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using... (More)
Background: While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods: A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (< 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results: Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions: Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Health Services Research
volume
12
issue
15
publisher
BioMed Central
external identifiers
  • wos:000301054300001
  • scopus:84855863131
ISSN
1472-6963
DOI
10.1186/1472-6963-12-15
language
English
LU publication?
yes
id
02bf8483-5576-4193-9e66-2207bc1094fb (old id 2384548)
date added to LUP
2012-04-02 09:23:54
date last changed
2017-08-27 04:33:10
@article{02bf8483-5576-4193-9e66-2207bc1094fb,
  abstract     = {Background: While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods: A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (&lt; 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results: Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions: Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not.},
  author       = {Librero, Julian and Peiro, Salvador and Leutscher, Edith and Merlo, Juan and Bernal-Delgado, Enrique and Ridao, Manuel and Martinez-Lizaga, Natalia and Sanfelix-Gimeno, Gabriel},
  issn         = {1472-6963},
  language     = {eng},
  number       = {15},
  publisher    = {BioMed Central},
  series       = {BMC Health Services Research},
  title        = {Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System},
  url          = {http://dx.doi.org/10.1186/1472-6963-12-15},
  volume       = {12},
  year         = {2012},
}