Discharge after hip fracture surgery by mobilisation timing: secondary analysis of the UK National Hip Fracture Database.
Objective To determine whether mobilisation timing was associated with the cumulative incidence of hospital discharge by 30 days after hip fracture surgery, accounting for potential confounders and the competing risk of in-hospital death. Method We examined data for 135,105 patients 60 years or olde...
| Publicado en: | Age & Ageing Vol. 50; no. 2; pp. 415 - 423 |
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| Autores principales: | , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Mar2021
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=149018068&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 149018068 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Mar2021 vid: 50 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 149018068 10.1093/ageing/afaa204 ppf: 415 ppct: 8 formats: tig: atl: Discharge after hip fracture surgery by mobilisation timing: secondary analysis of the UK National Hip Fracture Database. aug: au: Sheehan, Katie J Goubar, Aicha Almilaji, Orouba Martin, Finbarr C Potter, Chris Jones, Gareth D Sackley, Catherine Ayis, Salma affil: Faculty of Life Science and Medicine , Department of Population Health Sciences, School of Population Health & Environmental Sciences, King's College London , London, UK Guy's and St. Thomas' National Health Service Foundation Trust London , London, UK su: Wales England United Kingdom Mortality risk factors Length of stay in hospitals Range of motion of joints Confidence intervals Physical therapy Disease incidence Early ambulation (Rehabilitation) Hip joint injuries Descriptive statistics Odds ratio Bone fractures Discharge planning Secondary analysis sug: subj: Wales England United Kingdom Mortality risk factors Length of stay in hospitals Range of motion of joints Confidence intervals Physical therapy Disease incidence Early ambulation (Rehabilitation) Hip joint injuries Descriptive statistics Odds ratio Bone fractures Discharge planning Secondary analysis keyword: audit competing event early mobilisation hip fracture length of stay older people audit competing event early mobilisation hip fracture length of stay older people ab: Objective To determine whether mobilisation timing was associated with the cumulative incidence of hospital discharge by 30 days after hip fracture surgery, accounting for potential confounders and the competing risk of in-hospital death. Method We examined data for 135,105 patients 60 years or older who underwent surgery for nonpathological first hip fracture between 1 January 2014 and 31 December 2016 in any hospital in England or Wales. We tested whether the cumulative incidences of discharge differed between those mobilised early (within 36 h of surgery) and those mobilised late, accounting for potential confounders and the competing risk of in-hospital death. Results A total of 106,722 (79%) of patients first mobilised early. The average rate of discharge was 39.2 (95% CI 38.9–39.5) per 1,000 patient days, varying from 43.1 (95% CI 42.8–43.5) among those who mobilised early to 27.0 (95% CI 26.6–27.5) among those who mobilised late, accounting for the competing risk of death. By 30-day postoperatively, the crude and adjusted odds ratios of discharge were 2.36 (95% CI 2.29–2.43) and 2.08 (95% CI 2.00–2.16), respectively, among those who first mobilised early compared with those who mobilised late, accounting for the competing risk of death. Conclusion Early mobilisation led to a 2-fold increase in the adjusted odds of discharge by 30-day postoperatively. We recommend inclusion of mobilisation within 36 h of surgery as a new UK Best Practice Tariff to help reduce delays to mobilisation currently experienced by one-fifth of patients surgically treated for hip fracture. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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