Cecília SURJÁN, Semmelweis University, Health Services Management Training Centre, Budapest
Background: Hip fractures present a large burden on healthcare systems. In Hungary every year 12-14.000 people suffer such an accident. Recovery of the patients requires surgical care as well as coordinated multidisciplinary rehabilitation programmes. The EU projects EuroHOPE and Bridge aimed to explore the characteristics of hip fracture care in 7 countries from 2006 to 2014. According to these, short term mortality (7-30 days after first hospital admission with hip fracture) is similar in the countries, whereas 1-year mortality shows significant differences. While the rates in other countries vary between 19-27%, they remain over 35% in Hungary in the study period, peaking between 30-90 days from the incident. Our preliminary literature review revealed the most important factors influencing mortality: health status, comorbidities and socio-economic situation; and the organisation of rehabilitation. Our current goal was to explore the causes behind short to mid-term mortality to explain the Hungarian results.
Methods: A literature review conducted in the PubMed database. Search terms were: “hip fracture” AND “risk factor” AND (“early mortality” OR “cause of death” OR “mid-term mortality” OR “effectiveness of rehabilitation” OR “home care”). Search was limited to English language articles published in the last 5 years. Papers were screened based on relevance (yes/no). The main conclusions were compared to the data from the above mentioned projects.
Results: We found 145 articles. Title and abstract screening limited them to 23 for full-text screening. The most important identified factors are: functional status, infections (pneumonia, chest, urinary tract or periprosthetic), cardiovascular diseases and accident-to-surgery time.
Conclusion: Based on our data, accident-to-surgery time does not influence the outcomes significantly. Our further patient-level multivariate analyses will focus on the effects comorbidities and infections, while regional-level analyses of aggregated data will explore the effects of healthcare organisation and socio-economic status.
Doctoral School: Semmelweis University, Mental Health Sciences
Program: Mental Health Sciences
Supervisor: Éva BELICZA