Evidence map›Paper›PMID 35024971›Full record

Observational studyArchives of osteoporosis2022

Access to care for low trauma hip fractures in South Africa.

Sapna Shivani Dela, Farhanah Paruk, Magda Conradie, Jacobus Daniel Jordaan, Asgar Ali Kalla, Mkhululi Lukhele, Bilkish Cassim

Erratum issuedAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Archives of osteoporosis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Sapna Shivani DelaDepartment of Internal Medicine, Edendale Hospital, School of Clinical Medicine, University of KwaZulu-Natal, 89 Selby Msimang Rd, Plessislaer, Pietermaritzburg, KwaZulu-Natal, 3201, South Africa. sapnadela@gmail.com.
Farhanah ParukDepartment of Rheumatology, Department of Geriatrics, Division of Internal Medicine, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, 719 Umbilo Rd, Umbilo, Berea, Durban, 4001, South Africa.
Magda ConradieDepartment of Medicine, Division of Endocrinology, Faculty of Medicine and Health Sciences, Tygerberg Campus, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Jacobus Daniel JordaanDivision of Orthopaedics, Faculty of Medicine and Health Sciences, Tygerberg Campus, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Asgar Ali KallaDepartment of Medicine, Division of Rheumatology, Faculty of Health Sciences, University of Cape Town, Old Main Building, J-Floor, Groote Schuur Hospital Observatory, Cape Town, 7925, South Africa.
Mkhululi LukheleDepartment of Orthopaedics, Wits Division of Orthopaedic Surgery, University of Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
Bilkish CassimDepartment of Geriatrics, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, 719 Umbilo Rd, Umbilo, Berea, 4001, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleEarly surgery is recommended for hip fractures. MAIN

resultIn this study only one-third of subjects with hip fractures were admitted within 24 h of the fracture, and surgery was delayed beyond 48 h in the majority. SIGNIFICANCE: These findings highlight the need to improve access to care for hip fracture subjects. PURPOSE: There is limited data on the timing of admission and surgery following a low trauma hip fracture (HF) in South Africa (SA).

methodsA prospective, observational study was conducted at public and private hospitals in three provinces, Gauteng (GP), KwaZulu-Natal (KZN) and the Western Cape (WC), in SA to determine time from fracture to admission and from admission to surgery in patients presenting with low trauma HF. Associations with delayed admission and surgery were explored using logistic regression.

resultsThe median age of the 1996 subjects was 73 years (IQR 63-81 years), the majority were women (1346, 67%) and 1347 (67%) were admitted to the public hospitals. In one-third of subjects (661, 33%), admission was delayed to beyond 24 h after the fracture. There was a significantly longer time to admission in public compared to private hospitals (21 h [IQR 10.0-48.5] versus 6 h [IQR 3.3-14.1], p < 0.001), in subjects < 65 years, the WC and when admission occurred on a weekday. Surgery was delayed beyond 48 h in the majority (1272, 69%) of subjects and was significantly longer in public compared to private hospitals (130 h [IQR 62.6-212.4] versus 45.4 h [IQR 24.0-75.5], p < 0.001), in KZN, and when admission occurred after hours.

conclusionThe burden of HFs is higher at public hospitals in SA, where there is a significant delay in admission after a fracture and surgery after admission. This highlights the need for a review of HF care pathways, resources and policies.

Indexed as

Hip FracturesOsteoporotic FracturesAgedAged, 80 and overFemaleHealth Services AccessibilityHumansMaleMiddle AgedProspective StudiesRetrospective StudiesSouth AfricaDelayed admissionDelayed surgeryHip fracturesSouth Africa

Identifiers

PMID35024971

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.