ArticleActa orthopaedica2021
Poor adherence to guidelines in treatment of fragile and cognitively impaired patients with hip fracture: a descriptive study of 2,804 patients.
Article in Acta orthopaedica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Interventions to improve hip fracture guideline adherence for time to surgery and early mobilization: a systematic review and meta-analysis.BMC geriatrics · 2025Pooled it
- No effect of hydroxyapatite-coated sliding hip screw threads on screw migration in the femoral head/neck of pertrochanteric fractures: a randomized controlled trial using radiostereometric analysis.Journal of orthopaedic surgery and research · 2023Trial
- Clinical profiles and outcomes of different therapeutic protocols in elderly patients with trochanteric fractures: a descriptive study.Frontiers in medicine · 2026Article
- Impact of a national reimbursement policy on anti-osteoporosis medication prescription at discharge after hip-fracture surgery in Japan: an interrupted time-series analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Effects of Protocol-driven Care by Internists on Adherence to Clinical Practice Guidelines for Hip Fracture Surgery Patients: An Interrupted Time Series Study Using a Nationwide Inpatient Database.Internal medicine (Tokyo, Japan) · 2025Article
- Disparities in the Diagnosis and Treatment of Osteoporosis in Persons with Cognitive Impairment and Dementia.Current osteoporosis reports · 2025Review
- First year report of the IMSS Multicenter Hip Fracture Registry.Archives of osteoporosis · 2024Observational
- Investigating the link between frailty and outcomes in geriatric patients with isolated rib fractures.Trauma surgery & acute care open · 2024Article
- Are hip fracture patients with high or low body mass index at higher risk of missed care? A cohort study.Nursing open · 2023Article
- The majority of community-dwelling hip fracture patients return to independent living with minor increase in care needs: a prospective cohort study.Archives of orthopaedic and trauma surgery · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Following a hip fracture, most patients will encounter poorer functional outcomes and an increased risk of death. Treatment-monitoring of hip fracture patients is in many countries done by national audits. However, they do not allow for a deeper understanding of treatment limitations. We performed a local evaluation study to investigate adherence to 7 best-practice indicators, and to investigate patient groups at risk of suboptimal treatment.Patients and methods - 2,804 patients were surgically treated for a hip fracture from 2011 to 2017 at our institution. Data regarding admission, hospital stay, and discharge was prospectively collected, and adherence to the 7 best practice indicators (nerve block, surgical delay, antibiotics, implant choice, thromboprophylaxis, mobilization, and blood transfusions) was analyzed. Patient groups with lower adherence were identified.Results - 34% of patients received all 7 best practice indicators after considering contraindications; in particular, nerve blocks and thromboprophylaxis displayed low adherence at 61% and 91% respectively. Nursing home residents and patients with cognitive impairment, multiple comorbidities, or low functional levels were at risk of having a lower adherence.Interpretation - The most dependent patients with cognitive impairment, comorbidities, or low functional levels had lower guideline adherence. This large patient subgroup needs a higher treatment focus and more resources. Our findings are likely similar to those in other national and international institutions.
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