Ellanti Prasad, Cushen Breda, Galbraith Adam, Brent Louise, Hurson Conor, Ahern Emer
Department of Trauma and Orthopaedics, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Geriatric Medicine, St. Luke's General Hospital, Kilkenny, Ireland.
J Osteoporos. 2014;2014:656357. doi: 10.1155/2014/656357. Epub 2014 Dec 8.
Introduction. Hip fractures are common injuries in the older persons, with significant associated morbidity and mortality. The Irish Hip Fracture Database (IHFD) was implemented to monitor standards of care against international standards. Methods. The IHFD is a clinically led web-based audit. We summarize the data collected on hip fractures from April 2012 to March 2013 from 8 centres. Results. There were 843 patients with the majority being (70%) female. The 80-89-year age group accounted for the majority of fractures (44%). Most (71%) sustained a fall at home. Intertrochanteric fractures (40%) were most common. Only 28% were admitted to an orthopaedic ward within 4 hours. The majority (97%) underwent surgery with 44% having surgery within 36 hours. Medical optimization (35%) and lack of theatre space (26%) accounted for most of the surgical delay. While 29% were discharged home, 33% were discharged to a nursing home or other long-stay facilities. There was a 4% in-hospital mortality rate. Conclusions. Several key areas in both the database and aspects of patient care needing improvement have been highlighted. The implementation of similar databases has led to improved hip fracture care in other countries and we believe this can be replicated in Ireland.
引言。髋部骨折是老年人常见的损伤，伴有显著的相关发病率和死亡率。爱尔兰髋部骨折数据库（IHFD）的建立是为了对照国际标准监测护理水平。方法。IHFD是一项以临床为主导的基于网络的审核。我们总结了2012年4月至2013年3月期间从8个中心收集的髋部骨折数据。结果。共有843例患者，其中大多数（70%）为女性。80 - 89岁年龄组的骨折患者占大多数（44%）。大多数（71%）在家中跌倒。转子间骨折（40%）最为常见。只有28%的患者在4小时内被收入骨科病房。大多数（97%）接受了手术，其中44%在36小时内进行了手术。手术延迟的主要原因是医疗优化（35%）和手术室空间不足（26%）。29%的患者出院回家，33%的患者出院后入住养老院或其他长期护理机构。住院死亡率为4%。结论。突出显示了数据库和患者护理方面几个需要改进的关键领域。在其他国家，类似数据库的建立已使髋部骨折护理得到改善，我们相信这在爱尔兰也可以效仿。
