Abstract
Summary
Hip fracture registries have helped improve quality of care and reduce variability, and several audits exist worldwide. The results of the Spanish National Hip Fracture Registry are presented and compared with 13 other national registries, highlighting similarities and differences to define areas of improvement, particularly surgical delay and early mobilization.
Introduction
Hip fracture audits have been useful for monitoring current practice and defining areas in need of improvement. Most established registries are from Northern Europe. We present the results from the first annual report of the Spanish Hip Fracture Registry (RNFC) and compare them with other publically available audit reports.
Method
Comparison of the results from Spain with the most recent reports from another ten established hip fracture registries highlights the differences in audit characteristics, casemix, management, and outcomes.
Results
Of the patients treated in 54 hospitals, 7.208 were included in the registry between January and October 2017. Compared with other registries, the RNFC included patients ≥ 75 years old; in general, they were older, more likely to be female, had a worse prefracture ambulation status, and were more likely to have extracapsular fractures. A larger proportion was treated with intramedullary nails than in other countries, and spinal anesthesia was most commonly used. With a mean of 75.7 h, Spain had by far the longest surgical delay, and the lowest proportion of patients mobilized on the first postoperative day (58.5%). Consequently, development of pressure ulcers was high, but length of stay, mortality, and discharge to home remained in the range of other audits.
Conclusions
National hip fracture registries have proved effective in changing clinical practice and our understanding of patients with this condition. Such registries tend to be based on an internationally recognized common dataset which would make comparisons between national registries possible, but variations such as age inclusion criteria and follow-up are becoming evident across the world. This variation should be avoided if we are to maximize the comparability of registry results and help different countries learn from each other’s practice. The results reported in the Spanish RNFC, compared with those of other countries, highlight the differences between countries and detect areas of improvement, particularly surgical delay and early mobilization.
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Acknowledgements
The sponsors were not involved in any aspect of the project or in preparation of the manuscript. Special thanks to Mr. Jesús Martín García from BSJ-Marketing for his administrative assistance in editing the RNFC Annual Report.
Funding
This study was funded by AMGEN SA, UCB Pharma, Abbott Laboratories and FAES Farma, as well as a research grant awarded by the Fundación Mutua Madrileña (grant number AP169672018).
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The following authors have no conflicts of interest to declare: Currie CT5, Alarcón T2,8, Gómez-Campelo P2,11, Gil-Garay E2,8, Larrainzar-Garijo R15, Navarro-Castellanos L2, Otero-Puime A2,21.
The following authors declare:
Ojeda-Thies C1 has received honoraria for speaking at symposia from Amgen and financial support for attending symposia from Amgen and UCB Pharma; none of them related with the present work.
Sáez López P2,3,4 has received honoraria for speaking at symposia and financial support for attending symposia from Abbott, Nestlé and Amgen, none of them related with the present work.
Tarazona-Santalbina FJ6,7 has received honoraria for speaking at symposia and financial support for attending symposia from Lilly, Abbott, and Amgen; none of them related with the present work.
Muñoz-Pascual A9 has received financial support for attending symposia from Nutricia laboratories; none of them related with the present work.
Pareja T10 has received honoraria for speaking at symposia from Abbott and financial support for attending symposia from AMGEN and Vifor Pharma; none of them related with the present work.
Montero-Fernández N12,13 has received honoraria for speaking at symposia from Abbott, and financial support for attending symposia and educational programs from Abbott, Amgen, and Eli-Lilly; none of them related with the present work.
Mora-Fernández J14 has received honoraria for speaking at symposia, financial support for attending symposia, and support as a project sponsor from Amgen, Lilly, and UCB Pharma; none of them related with the present work.
Etxebarría-Foronda I16 has received honoraria for peaking at symposia from Eli-Lilly; none of them related with the present work.
Caeiro JR17 has received financial support for attending symposia and support for educational programs of Amgen, Lilly, Stryker, and Zimmer Companies; none of them related with the present work.
Díez-Pérez A18 is advisor of has received speaker honoraria from AMGEN, UCB, Lilly, Gilead, Roche, and EchoLight and owns stocks from Active Life Sci; none of them related with the present work.
Prieto-Alhambra D’s19,20 research group has received grants from UCB, and speaker fees (paid to his department) from Amgen and UCB, and consultancy fees (paid to his department) from Amgen, Janssen, and UCB; none of them related with the present work.
González-Montalvo JI2,8 has received research grants from Nestlé Health Science and Abbott Nutrition; has received speaker honoraria from Nutricia, Nestlé Health Science, Amgen, and Abbott Nutrition; and has received financial support for educational programs from Nutricia and Amgen. None of them related with the present work.
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Ojeda-Thies, C., Sáez-López, P., Currie, C. et al. Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries. Osteoporos Int 30, 1243–1254 (2019). https://doi.org/10.1007/s00198-019-04939-2
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DOI: https://doi.org/10.1007/s00198-019-04939-2