Improving fragility hip fracture care through data: a multicentre experience from a country with an emerging economy during the COVID-19 pandemic.

Autor:	Tabu IA; Department of Orthopedics, Philippine General Hospital, University of the Philippines, Manila, Philippines iatabu@up.edu.ph ksaraneta1@gmail.com.; Institute on Aging, National Institutes of Health, UP Manila, Philippines., Araneta KTS; Department of Orthopedics, Western Visayas Medical Center, Iloilo City, Philippines iatabu@up.edu.ph ksaraneta1@gmail.com., Alpuerto BB 2nd; Department of Orthopedics, Philippine General Hospital, University of the Philippines, Manila, Philippines., Delgado GD; Department of Orthopedics, Philippine General Hospital, University of the Philippines, Manila, Philippines., Lai JGL; Department of Orthopedics, Philippine General Hospital, University of the Philippines, Manila, Philippines.; Department of Orthopedics, Cardinal Santos Medical Center, San Juan, Philippines., San Juan JAG; Department of Orthopedics, Chong Hua Hospital, Cebu City, Philippines., Ho A Jr; Department of Orthopedics, Chong Hua Hospital, Cebu City, Philippines., Reyes MRB; Department of Orthopedics, Davao Doctors Hospital, Davao City, Philippines., De Vera J; Department of Orthopedics, De Los Santos Medical Center, Quezon City, Philippines., Syquia JFC; Department of Orthopedics, De Los Santos Medical Center, Quezon City, Philippines., Manalastas REC; Department of Orthopedics, Jose B. Lingad Memorial Regional Hospital, San Fernando, Philippines., Tablante AJC; Department of Orthopedics, Jose R. Reyes Memorial Medical Center, Manila, Philippines., Brabante AMT; Philippine Orthopedic Center, Quezon City, Philippines., Dimayuga CCD; Department of Orthopedics, Philippine General Hospital, University of the Philippines, Manila, Philippines.; Department of Orthopedics, The Medical City, Pasig City, Philippines., Pacheco DM; Department of Orthopedics, Veterans Memorial Medical Center, Quezon City, Philippines., Baclig PY; Department of Orthopedics, Vicente Sotto Memorial Medical Center, Cebu City, Philippines., Co AST; Department of Orthopedics, Vicente Sotto Memorial Medical Center, Cebu City, Philippines., Yap JAD; Department of Orthopedics, West Visayas State University Medical Center, Iloilo City, Philippines.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2023 Sep; Vol. 12 (Suppl 2).
DOI:	10.1136/bmjoq-2023-002299
Abstrakt:	Introduction: In low-to-middle-income countries (LMIC), the orthogeriatric model of care is still in its early stages of development. This study describes the initial results of the first online fragility hip fracture database to be setup in the Philippines using a modified minimum common dataset to generate outcomes data based on current hospital practices. Methods: A multicentre prospective cohort study among 12 Philippine hospitals was conducted from June 2020 to February 2021. Thirty-day mortality, morbidity and mobility were measured. Significant factors associated with mortality were determined. Results: 158 elderly patients with fragility hip fractures were included in the study. Nine patients (5.7%) were confirmed or suspected to have COVID-19 infection. Median time of injury to admission was at least 3 days (IQR: 1.0-13.7). Overall, 80% of patients underwent surgical intervention with a median time from admission to surgery of at least 5 days (IQR: 2.5-13.6). Thirty-day mortality and morbidity rates for acute fragility fractures were 3.7%. Factors significantly associated with early mortality were poor prefracture mobility, COVID-19 infection, radiograph of the abnormal chest and conservative treatment. Non-surgical patients had no functional mobility or were wheelchair users and had a significantly higher morbidity rate than surgically treated patients (13.6% vs 1.8%; p=0.031). Conclusion: Despite treatment delays unique to an LMIC, short-term outcomes remain favourable for non-COVID-19 fragility hip fracture patients treated with surgery. Prompt admission and multidisciplinary care for elderly hip fracture patients while maintaining protective measures for COVID-19 infection control are recommended. The quality of data collected illustrates how this online database can provide a framework for a sustainable audit or registry as well as provide a platform for the introduction of orthogeriatric concepts at a multiregional scale. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu