TY - JOUR
T1 - Trends in hip fracture surgery in the United States from 2016 to 2021
T2 - patient characteristics, clinical management, and outcomes
AU - Hong, Genewoo
AU - Zhong, Haoyan
AU - Illescas, Alex
AU - Reisinger, Lisa
AU - Cozowicz, Crispiana
AU - Poeran, Jashvant
AU - Liu, Jiabin
AU - Memtsoudis, Stavros G.
N1 - Cozowicz: Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria; Memtsoudis: externe Aff.
PY - 2024/11
Y1 - 2024/11
N2 - Introduction: Hip fractures are a serious health concern and a major contributor to healthcare resource utilisation. We aimed to investigate nationwide trends in the USA in patient characteristics and outcomes in patients after hip fracture repair surgery. Methods: From the Premier Healthcare dataset, we extracted patient encounters for surgical hip fracture repair from 2016 to 2021. Patient characteristics, comorbidities, complications, and anaesthetic and surgical details were analysed. Cochran-Armitage trend tests and simple linear regression were used to determine trends. Results: We included 347 086 hip fracture repair encounters. Notable trends included the following: median patient age declined from 82 yr [interquartile range: 73-88 yr] to 81 yr [interquartile range: 73-88 yr], (P-value=0.002), = 0.002), the proportion of female patients decreased from 68% to 66.2% (P-value=0.019); = 0.019); internal fixation was the most common intervention initially, but with a declining percentage from 49.9% to 43.8% (P-value < 0.001); in general, patients carried a greater comorbidity burden, with the proportion with three or more Elixhauser comorbidities increasing from 56.4% to 58.6% (P-value=0.006); = 0.006); general anaesthesia remained the most common anaesthetic technique, from 68.90% to 56.80% without a significant trend; per 1000 inpatient days, the most common complication remained acute renal failure; despite a higher comorbidity burden, no complication showed a statistically significant upward trend, and many showed downward trends. Conclusions: Over the 6-yr period from 2016 to 2021, a majority of hip fracture repairs continued to be performed under general anaesthesia but with that percentage declining over time. Notable trends included a lower percentage of female patients, an increase in femoral neck fractures, a higher comorbidity burden among patients, and a decrease in complications.
AB - Introduction: Hip fractures are a serious health concern and a major contributor to healthcare resource utilisation. We aimed to investigate nationwide trends in the USA in patient characteristics and outcomes in patients after hip fracture repair surgery. Methods: From the Premier Healthcare dataset, we extracted patient encounters for surgical hip fracture repair from 2016 to 2021. Patient characteristics, comorbidities, complications, and anaesthetic and surgical details were analysed. Cochran-Armitage trend tests and simple linear regression were used to determine trends. Results: We included 347 086 hip fracture repair encounters. Notable trends included the following: median patient age declined from 82 yr [interquartile range: 73-88 yr] to 81 yr [interquartile range: 73-88 yr], (P-value=0.002), = 0.002), the proportion of female patients decreased from 68% to 66.2% (P-value=0.019); = 0.019); internal fixation was the most common intervention initially, but with a declining percentage from 49.9% to 43.8% (P-value < 0.001); in general, patients carried a greater comorbidity burden, with the proportion with three or more Elixhauser comorbidities increasing from 56.4% to 58.6% (P-value=0.006); = 0.006); general anaesthesia remained the most common anaesthetic technique, from 68.90% to 56.80% without a significant trend; per 1000 inpatient days, the most common complication remained acute renal failure; despite a higher comorbidity burden, no complication showed a statistically significant upward trend, and many showed downward trends. Conclusions: Over the 6-yr period from 2016 to 2021, a majority of hip fracture repairs continued to be performed under general anaesthesia but with that percentage declining over time. Notable trends included a lower percentage of female patients, an increase in femoral neck fractures, a higher comorbidity burden among patients, and a decrease in complications.
KW - Covid-19
KW - United States
KW - Complications
KW - Hip fracture surgery
KW - Patient characteristics
KW - Trends
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001338977500001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1016/j.bja.2024.07.022
DO - 10.1016/j.bja.2024.07.022
M3 - Review article
C2 - 39242278
SN - 0007-0912
VL - 133
SP - 955
EP - 964
JO - BRITISH JOURNAL OF ANAESTHESIA
JF - BRITISH JOURNAL OF ANAESTHESIA
IS - 5
ER -