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How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong.
Leung, K S; Yuen, W F; Ngai, W K; Lam, C Y; Lau, T W; Lee, K B; Siu, K M; Tang, N; Wong, S H; Cheung, W H.
Afiliação
  • Leung KS; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Yuen WF; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Ngai WK; Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong.
  • Lam CY; Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Tuen Mun, Hong Kong.
  • Lau TW; Department of Orthopaedics and Traumatology, Queen Mary Hospital, Pokfulam, Hong Kong.
  • Lee KB; Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Jordan, Hong Kong.
  • Siu KM; Department of Orthopaedics and Traumatology, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Tang N; Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.
  • Wong SH; Department of Orthopaedics and Traumatology, Caritas Medical Centre, Shamshuipo, Hong Kong.
  • Cheung WH; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Med J ; 23(3): 264-71, 2017 Jun.
Article em En | MEDLINE | ID: mdl-28473651
ABSTRACT

INTRODUCTION:

In setting up a disease registry for fragility fractures in Hong Kong, we conducted a retrospective systematic study on the management of fragility hip fractures. Patient outcomes were compared with the standards from our orthopaedic working group and those from the British Orthopaedic Association that runs a mature fracture registry in the United Kingdom.

METHODS:

Clinical data on fragility hip fracture patients admitted to six acute major hospitals in Hong Kong in 2012 were captured. These included demographics, pre- and post-operative assessments, discharge details, complications, and 1-year follow-up information. Analysis was performed according to the local standards with reference to those from the British Orthopaedic Association.

RESULTS:

Overall, 91.0% of patients received orthopaedic care within 4 hours of admission and 60.5% received surgery within 48 hours. Preoperative geri-orthopaedic co-management was received by 3.5% of patients and was one of the reasons for the delayed surgery in 22% of patients. Only 22.9% were discharged with medication that would promote bone health. Institutionalisation on discharge significantly increased by 16.2% (P<0.001). Only 35.1% of patients attended out-patient follow-up 1 year following fracture, and mobility had deteriorated in 69.9% compared with the premorbid state. Death occurred in 17.3% of patients within a year of surgery compared with 1.6% mortality rate in a Hong Kong age-matched population.

CONCLUSIONS:

The efficiency and quality of acute care for fragility hip fracture patients was documented. Regular geri-orthopaedic co-management can enhance acute care. Much effort is needed to improve functional recovery, prescription of bone health medications, attendance for follow-up, and to decrease institutionalisation. A Fracture Liaison Service is vital to improve long-term care and prevent secondary fractures.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Sistema de Registros / Procedimentos Ortopédicos / Fraturas do Quadril Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Sistema de Registros / Procedimentos Ortopédicos / Fraturas do Quadril Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article