Research article summary (published 29 Sep 2004):

[Factors affecting quality of care for elderly subjects undergoing surgery for hip fracture: review of the literature]

(Facteurs de qualité de la prise en charge des sujets âgés opérés d'une fracture de l'extrémité supérieure du fémur: revue de la littérature.)

Full Abstract

Hip fractures are one of the leading causes for admission of elderly subjects to healthcare facilities. Because of population aging, the incidence of hip fractures has increased considerably over the last years and will continue to increase in industrialized countries. Hip fracture in an elderly subject may be life threatening and has a significant functional and social impact not only because of the fracture itself, but also because of the risk of complications related to the patient's health status and the long hospital stay. The purpose of this work was to identify in the published literature professional practices, excepting the surgical procedure, associated with better early and long-term outcome in elderly patients with hip fracture. Questions raised concerning the patient's hospital stay include factors related to the preoperative phase (time to surgery, usefulness of traction), the operation itself (antibiotic prophylaxis, anesthesia technique), and the postoperative phase (prevention of venous thrombosis, malnutrition, episodes of confusion, duration of indwelling bladder catheter, correction of anemia, geriatric care during the stay in the orthopedic ward, early and intense rehabilitation, prevention of recurrence). Among these factors, several appear to be associated with better outcome, including long-term outcome--surgery as early as possible in light of the patient's general status, antibiotic prophylaxis in accordance with standard recommendations (SFAR), prevention of venous thrombosis with low-molecular-weight heparin initiated at admission and associated with elastic contention. Oral nutritional support is probably beneficial and should be proposed for all patients. Particular attention must be given to prevention of confusion in order to reduce the rate of institutionalization. The rythm of rehabilitation exercises should be at least five sessions per week. Finally, there are several methods, which are effective in preventing recurrence, taking into account osteoporosis, risk of falls. Preventive measures should be instituted for all patients undergoing surgery for hip fracture.

Author information

Author/s: Merle, V (V); Moret, L (L); Josset, V (V); Pidhorz, L (L); Piétu, G (G); Gouin, F (F); Riou, F (F); Chassagne, P (P); Petit, J (J); Lombrail, P (P); Czernichow, P (P); Dujardin, F (F);

Affiliation: Département d'Epidémiologie et de Santé Publique, CHU de Rouen, Hôpitaux de Rouen, 1, rue de Germont, 76031 Rouen Cedex.

Journal and publication information

Publication Type: English Abstract; Journal Article; Review

Journal: Revue de chirurgie orthopédique et réparatrice de l'appareil moteur (Rev Chir Orthop Reparatrice Appar Mot), published in France. (Language: fre)

Reference: 2004-Oct; vol 90 (issue 6) : pp 504-16

Dates: Created 2005/01/27; Completed 2005/09/13; Revised 2006/11/15;

PMID: 15672917, status: MEDLINE (last retrieved date: 2/18/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Aged Hip Fractures - surgery Humans Postoperative Care

Postoperative Care Postoperative Complications - prevention & control Preoperative Care Quality of Health Care

Note: Bold headings indicate primary MeSH headings or qualifiers.

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