Evidence map›Paper›PMID 36041740›Full record

ArticleAge and ageing2022

Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study.

Rita Patel, Andrew Judge, Antony Johansen, Elsa M R Marques, Jill Griffin, Marianne Bradshaw, Sarah Drew, Katie Whale, Tim Chesser, Xavier L Griffin and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
5.7field-weighted citation impact, top 3% of its field
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

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

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  9. Rapid transfer to specialist orthopaedic ward reduces mortality in hip fracture patients, but several factors reduce the ability to achieve the < 4-hour target.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 1 country.

Rita PatelMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Andrew JudgeMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Antony JohansenDivision of Population Medicine, School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, UK.
Elsa M R MarquesMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Jill GriffinClinical & Operations Directorate, Royal Osteoporosis Society, Bath, UK.
Marianne BradshawMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Sarah DrewMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Katie WhaleMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Tim ChesserDepartment of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Xavier L GriffinBarts Bone and Joint Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Muhammad K JavaidNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Yoav Ben-ShlomoPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Celia L GregsonMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
University of Bristol · GBCardiff University · GBNorth Bristol NHS Trust · GBRoyal London Hospital · GBRoyal Osteoporosis Society · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity of Oxford · GB

Funding

Department of HealthVersus Arthritis 22086
6 · The paper itself

Abstract

objectivesDespite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across the United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the months following hip fracture.

methodsWe examined a national record-linkage cohort of 178,757 patients aged ≥60 years who sustained a hip fracture in England and Wales in 2016-19. Patient-level hospital admissions datasets, National Hip Fracture Database and mortality data were linked to metrics from 18 hospital-level organisational-level audits and reports. Multilevel models identified organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality and emergency 30-day readmission.

resultsAcross hospitals mean LOS ranged from 12 to 41.9 days, mean 30-day mortality from 3.7 to 10.4% and mean readmission rates from 3.7 to 30.3%, overall means were 21.4 days, 7.3% and 15.3%, respectively. In all, 22 organisational factors were independently associated with LOS; e.g. a hospital's ability to mobilise >90% of patients promptly after surgery predicted a 2-day shorter LOS (95% confidence interval [CI]: 1.2-2.6). Ten organisational factors were independently associated with 30-day mortality; e.g. discussion of patient experience feedback at clinical governance meetings and provision of prompt surgery to >80% of patients were each associated with 10% lower mortality (95%CI: 5-15%). Nine organisational factors were independently associated with readmissions; e.g. readmissions were 17% lower if hospitals reported how soon community therapy would start after discharge (95%CI: 9-24%).

conclusionsReceipt of hip fracture care should be reliable and equitable across the country. We have identified multiple, potentially modifiable, organisational factors associated with important patient outcomes following hip fracture.

Indexed as

Hip FracturesHospitalsCohort StudiesEnglandHumansLength of StayMiddle AgedPatient ReadmissionRisk FactorsTreatment OutcomeWaleship fracturelength of staymortalityorganisational factorspatient outcomes

Identifiers

PMID36041740
PMCPMC9427326
OpenAlexW4293858497

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.