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Article: How well are we managing fragility hip fractures? A narrative report on the review with the attempt to set up a fragility fracture registry in Hong Kong
Title | How well are we managing fragility hip fractures? A narrative report on the review with the attempt to set up a fragility fracture registry in Hong Kong 我們治理脆性髖部骨折是否理想?一個根據脆性骨折登記冊數據的敘述報告 |
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Authors | |
Issue Date | 2017 |
Citation | Hong Kong Medical Journal, 2017, v. 23, n. 3, p. 264-271 How to Cite? |
Abstract | Introduction: In setting up a disease registry for fragility fractures in Hong Kong, we conducted a retrospective systematic study on the management of fragility hip fractures. Patient outcomes were compared with the standards from our orthopaedic working group and those from the British Orthopaedic Association that runs a mature fracture registry in the United Kingdom. Methods: Clinical data on fragility hip fracture patients admitted to six acute major hospitals in Hong Kong in 2012 were captured. These included demographics, pre- and post-operative assessments, discharge details, complications, and 1-year follow-up information. Analysis was performed according to the local standards with reference to those from the British Orthopaedic Association. Results: Overall, 91.0% of patients received orthopaedic care within 4 hours of admission and 60.5% received surgery within 48 hours. Preoperative geri-orthopaedic co-management was received by 3.5% of patients and was one of the reasons for the delayed surgery in 22% of patients. Only 22.9% were discharged with medication that would promote bone health. Institutionalisation on discharge significantly increased by 16.2% (P<0.001). Only 35.1% of patients attended out-patient follow-up 1 year following fracture, and mobility had deteriorated in 69.9% compared with the premorbid state. Death occurred in 17.3% of patients within a year of surgery compared with 1.6% mortality rate in a Hong Kong age-matched population. Conclusions: The efficiency and quality of acute care for fragility hip fracture patients was documented. Regular geri-orthopaedic co-management can enhance acute care. Much effort is needed to improve functional recovery, prescription of bone health medications, attendance for follow-up, and to decrease institutionalisation. A Fracture Liaison Service is vital to improve long-term care and prevent secondary fractures. |
Persistent Identifier | http://hdl.handle.net/10722/296146 |
ISSN | 2023 Impact Factor: 3.1 2023 SCImago Journal Rankings: 0.261 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Leung, K. S. | - |
dc.contributor.author | Yuen, W. F. | - |
dc.contributor.author | Ngai, W. K. | - |
dc.contributor.author | Lam, C. Y. | - |
dc.contributor.author | Lau, T. W. | - |
dc.contributor.author | Lee, K. B. | - |
dc.contributor.author | Siu, K. M. | - |
dc.contributor.author | Tang, N. | - |
dc.contributor.author | Wong, S. H. | - |
dc.contributor.author | Cheung, W. H. | - |
dc.date.accessioned | 2021-02-11T04:52:56Z | - |
dc.date.available | 2021-02-11T04:52:56Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Hong Kong Medical Journal, 2017, v. 23, n. 3, p. 264-271 | - |
dc.identifier.issn | 1024-2708 | - |
dc.identifier.uri | http://hdl.handle.net/10722/296146 | - |
dc.description.abstract | Introduction: In setting up a disease registry for fragility fractures in Hong Kong, we conducted a retrospective systematic study on the management of fragility hip fractures. Patient outcomes were compared with the standards from our orthopaedic working group and those from the British Orthopaedic Association that runs a mature fracture registry in the United Kingdom. Methods: Clinical data on fragility hip fracture patients admitted to six acute major hospitals in Hong Kong in 2012 were captured. These included demographics, pre- and post-operative assessments, discharge details, complications, and 1-year follow-up information. Analysis was performed according to the local standards with reference to those from the British Orthopaedic Association. Results: Overall, 91.0% of patients received orthopaedic care within 4 hours of admission and 60.5% received surgery within 48 hours. Preoperative geri-orthopaedic co-management was received by 3.5% of patients and was one of the reasons for the delayed surgery in 22% of patients. Only 22.9% were discharged with medication that would promote bone health. Institutionalisation on discharge significantly increased by 16.2% (P<0.001). Only 35.1% of patients attended out-patient follow-up 1 year following fracture, and mobility had deteriorated in 69.9% compared with the premorbid state. Death occurred in 17.3% of patients within a year of surgery compared with 1.6% mortality rate in a Hong Kong age-matched population. Conclusions: The efficiency and quality of acute care for fragility hip fracture patients was documented. Regular geri-orthopaedic co-management can enhance acute care. Much effort is needed to improve functional recovery, prescription of bone health medications, attendance for follow-up, and to decrease institutionalisation. A Fracture Liaison Service is vital to improve long-term care and prevent secondary fractures. | - |
dc.language | eng | - |
dc.relation.ispartof | Hong Kong Medical Journal | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | How well are we managing fragility hip fractures? A narrative report on the review with the attempt to set up a fragility fracture registry in Hong Kong | - |
dc.title | 我們治理脆性髖部骨折是否理想?一個根據脆性骨折登記冊數據的敘述報告 | - |
dc.type | Article | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.12809/hkmj166124 | - |
dc.identifier.pmid | 28473651 | - |
dc.identifier.scopus | eid_2-s2.0-85020299772 | - |
dc.identifier.hkuros | 323572 | - |
dc.identifier.volume | 23 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 264 | - |
dc.identifier.epage | 271 | - |
dc.identifier.isi | WOS:000402949300010 | - |
dc.identifier.issnl | 1024-2708 | - |