Observational studyArchives of osteoporosis2017
Management of older adults with hip fractures in India: a mixed methods study of current practice, barriers and facilitators, with recommendations to improve care pathways.
Observational study in Archives of osteoporosis, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Can we ever have evidence-based decision making in orthopaedics? A qualitative evidence synthesis and conceptual framework.BMC medical informatics and decision making · 2025Pooled it
- Do we understand each other when we develop and implement hip fracture models of care? A systematic review with narrative synthesis.BMJ open quality · 2023Pooled it
- Hidden blood loss after proximal femur fractures fixation: analysis of the first three postoperative days and influence of anticoagulants.Archives of orthopaedic and trauma surgery · 2026Article
- Difference in discharge disposition, adherence to clinical care standards and functional outcomes of older hip fracture patients receiving an orthogeriatric model of care versus routine care.Journal of orthopaedic surgery and research · 2025Article
- Mortality among elderly hip fracture patients following surgical intervention- an institutional review of a tertiary care centre of North India.Journal of clinical orthopaedics and trauma · 2025Article
- Narrative Review on the Management of Neck of Femur Fractures in People Living with HIV: Challenges, Complications, and Long-Term Outcomes.Microorganisms · 2025Review
- Article
- Structured Exercise Program for Hip Arthroplasty: An Expert Consensus Using the Delphi Technique.Indian journal of orthopaedics · 2025Article
- Demographic Insights into One-Year Mortality Following Proximal Femur Fracture Surgery in India.Journal of orthopaedic case reports · 2025Article
- Paramedics and emergency medical technicians' perceptions of geriatric trauma care in Saudi Arabia.BMC emergency medicine · 2025Article
- Hip biomechanics, health-related quality of life and walking ability after intramedullary fixation in intertrochanteric fracture: a prospective cohort study.International journal of burns and trauma · 2025Article
- Article
- Benchmarking institutional geriatric hip fracture management: a prelude to a care quality improvement initiative.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Article
- The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?Hip & pelvis · 2023Article
- Understanding factors influencing the use of clinical guidelines in low-income and middle-income settings: a scoping review.BMJ open · 2023Article
- Interventions for reducing red blood cell transfusion in adults undergoing hip fracture surgery: an overview of systematic reviews.The Cochrane database of systematic reviews · 2023Review
- The Outcome of Surgically Treated Proximal Femur Fractures Managed by Ortho-anesthetic Geriatric Care Pathway: A Prospective Observational Study with 2-Year Follow-Up.Indian journal of orthopaedics · 2023Article
- Mobility and mortality outcomes among older individuals with hip fractures at a teaching hospital in Malaysia.Archives of osteoporosis · 2022Observational
- Identifying Opportunities, and Motivation to Enhance Capabilities, Influencing the Development of a Personalized Digital Health Hub Model of Care for Hip Fractures: Mixed Methods Exploratory Study.Journal of medical Internet research · 2021Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Evidence-based management can reduce deaths and suffering of older adults with hip fractures. This study investigates the evidence-practice gaps in hip fracture care in three major hospitals in Delhi, potential barriers and facilitators to improving care, and consequently, identifies contextually appropriate interventions for implementing best practice for management of older adults with hip fractures in India. PURPOSE: Hip fracture in older adults is a significant public health issue in India. The current study sought to document current practices, identify barriers and facilitators to adopting best practice guidelines and recommend improvements in the management of older adults with hip fractures in Delhi, India.
methodsThis mixed methods observational study collected data from healthcare providers, patients, carers and medical records from three major public tertiary care hospitals in Delhi, India. All patients aged ≥50 years with an X-ray confirmed hip fracture that were admitted to these hospitals over a 10-week period were recruited. Patients' data were collected at admission, discharge and 30 days post-injury. Eleven key informant interviews and four focus group discussions were conducted with healthcare providers. Descriptive data for key quantitative variables were computed. The qualitative data were analysed and interpreted using a behaviour change wheel framework.
resultsA total of 136 patients, 74 (54%) men and 62 women, with hip fracture were identified in the three participating hospitals during the recruitment period and only 85 (63%) were admitted for treatment with a mean age of 66.5 years (SD 11.9). Of these, 30% received surgery within 48 h of hospital admission, 95% received surgery within 39 days of hospital admission and two (3%) had died by 30 days of injury. According to the healthcare providers, inadequate resources and overcrowding prevent adequate caring of the hip fracture patients. They unanimously felt the need for protocol-based management of hip fracture in India.
conclusionThe development and implementation of national guidelines and standardized protocols of care for older people with hip fractures in India has the potential to improve both care and patient-related outcomes.
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