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Clinical Advances in Hip Fracture Management and Care
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Clinical Advances in Hip Fracture Management and Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 15 October 2024 | Viewed by 1193

Special Issue Editor

Dr. Nicholas David Clement

E-Mail Website
Guest Editor
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
Interests: arthroplasty; hip fracture; outcomes

Special Issue Information

Dear Colleagues,

The number and incidence of hip fractures are increasing and are associated with increased morbidity, increased frailty, and mortality risk. Therefore, optimising the management of these patients is important for the patient to ensure their best outcomes in healthcare systems where an increasing number of patients are presenting with this injury.

Despite the vast amount research around hip fracture care, unanswered issues remain in relation to time to theatre, perioperative care, minimising the length of hospital stay, returning to place of domicile, deep infection, the failure of fixation/revision, and limiting the frailty associated with injury and mortality risk.

This Special Issue will focus on the epidemiology, outcomes, and care of individuals with hip fractures. The aim is to produce a Special Issue that provides readers with current information on the care of these individuals following their injury to help optimise management.

Dr. Nicholas David Clement
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • arthroplasty
  • hip fracture
  • epidemiology
  • outcomes
  • management

Published Papers (2 papers)

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Research

15 pages, 1476 KiB  
Article
The Impact of Hospital Transfers on Surgical Delay and Associated Postoperative Outcomes for Hip Fracture Patients in Scotland: A Cohort Study
by Liam Lennox, Phyo K. Myint, Santosh Baliga and Luke Farrow
J. Clin. Med. 2024, 13(9), 2546; https://doi.org/10.3390/jcm13092546 - 26 Apr 2024
Viewed by 223
Abstract
Background/Objectives: Hip fractures exert a substantial burden on hospital systems. Within Scotland 20% of the population resides rurally, warranting investigation of how this impacts prompt access to surgical care. This study aims to determine whether indirect hospital admission via hospital transfer affects [...] Read more.
Background/Objectives: Hip fractures exert a substantial burden on hospital systems. Within Scotland 20% of the population resides rurally, warranting investigation of how this impacts prompt access to surgical care. This study aims to determine whether indirect hospital admission via hospital transfer affects the likelihood of surgical management within 36 h for hip fracture patients. Methods: A retrospective cohort study was performed. This used Scottish Hip Fracture Audit data including patients aged ≥50 split into two propensity matched groups based on their transfer status. Descriptive analysis compared patient characteristics. Regression assessed achieving surgery within 36 h of admission in the unmatched and matched cohorts. Secondary outcomes included time to surgery, mortality, mobilization, returning to residence and length of stay. A sensitivity analysis was undertaken to assess for residual confounding effects. Results: The unmatched analysis included 20,132 patients. Transfer patients were younger (p = 0.007) and less-comorbid (p < 0.001). In the matched population, 711 (63.6%) transfer patients had surgery with 36 h of presentation to hospital, compared to 852 (75.3%) non-transfer patients. Transfer patients had 43% reduced odds of timely surgery (OR (95% CI) 0.57 (0.48 to 0.69); p < 0.001). No disparities emerged in mortality, mobilisation or returning to residence., Transfer patients experienced a significant increase in length of stay in hospital (median (IQR) 16 (8 to 33) vs. 13 (8 to 30); p = 0.024). Conclusions: Hospital transfer is associated with significantly reduced odds of timely surgery, a longer time to surgery and longer length of stay. Development of structured network pathways that minimize delay to transfer are required to potentially optimize outcomes and reduce associated cost. Full article
(This article belongs to the Special Issue Clinical Advances in Hip Fracture Management and Care)
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13 pages, 649 KiB  
Article
Completion of the Emergency Department “Big 6” in Patients with an Acute Hip Fracture Is Associated with a Lower Mortality Risk and Shorter Length of Hospital Stay
by Nick D. Clement, Rose S. Penfold, Andrew Duffy, Krishna Murthy, Alasdair M. J. MacLullich and Andrew D. Duckworth
J. Clin. Med. 2023, 12(17), 5559; https://doi.org/10.3390/jcm12175559 - 26 Aug 2023
Viewed by 698
Abstract
The aims of this study were to assess whether completion of the emergency department (ED) Big 6 interventions (provision of pain relief, screening for delirium, early warning score (EWS) system, full blood investigation and electrocardiogram, intravenous fluids therapy, and pressure area care) in [...] Read more.
The aims of this study were to assess whether completion of the emergency department (ED) Big 6 interventions (provision of pain relief, screening for delirium, early warning score (EWS) system, full blood investigation and electrocardiogram, intravenous fluids therapy, and pressure area care) in those presenting with an acute hip fracture were associated with mortality risk and length of acute hospital stay. A retrospective cohort study was undertaken. All patients aged ≥50 years that were admitted with a hip fracture via the ED at a single centre during a 42-month period were included. A total of 3613 patients (mean age 80.9; 71% female) were included. The mean follow up was 607 (range 240 to 1542) days. A total of 1180 (32.7%) patients had all six components completed. Pain relief (90.8%) was the most frequently completed component and pressure area assessment (57.6%) was the least. Completion of each of the individual Big 6 components, except for pressure areas assessment, were associated with a significantly (p ≤ 0.041) lower mortality risk at the 90-days, one-year and final follow-up. The completion of all components of the Big 6 was associated with a significantly (2.4 hours, p = 0.002) shorter time to theatre. Increasing number of Big 6 components completed were independently associated with a lower mortality risk: when all six were completed, the hazard ratio was 0.64 (95% CI 0.52 to 0.78, p < 0.001). Completion of an increasing number of Big 6 components was independently associated with shorter length of hospital stay and completion of all six was associated with a 2.3 (95% CI 0.9 to 3.8)-day shorter acute stay. The findings provide an evidence base to support the ongoing use of the Big 6 in the ED. Full article
(This article belongs to the Special Issue Clinical Advances in Hip Fracture Management and Care)
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