Evidence map›Paper›PMID 36161538›Full record

ArticleArchives of osteoporosis2022

Geographic variation in hip fracture surgery rate, care quality and outcomes: a comparison between national registries in Ireland and Denmark.

Mary E Walsh, Jan Sorensen, Catherine Blake, Søren Paaske Johnsen, Pia Kjær Kristensen

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In one paragraph

Article in Archives of osteoporosis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

5 authors.

Mary E WalshSchool of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland. m.walsh@ucd.ie.ORCID http://orcid.org/0000-0001-8920-7419
Jan SorensenHealthcare Outcomes Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.ORCID http://orcid.org/0000-0003-0857-9267
Catherine BlakeSchool of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.ORCID http://orcid.org/0000-0002-0600-629X
Søren Paaske JohnsenDanish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.ORCID http://orcid.org/0000-0002-2787-0271
Pia Kjær KristensenThe Department of Clinical Medicine, Orthopaedic, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-5473-9386

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ireland and Denmark have similar hip fracture surgery rates but differences in care quality indicators and patterns of intracapsular fracture repair. Very high variation in total hip arthroplasty rate within both countries and higher observed early mortality in Denmark require further investigation. PURPOSE: To explore and compare geographic variation of hip fracture surgery rate, care quality and outcomes in Ireland and Denmark.

methodsPatients aged ≥ 65 years with surgically treated hip fracture were included from the Irish Hip Fracture Database (years = 2017-2020, n = 12,904) and the Danish Multidisciplinary Hip Fracture Registry (years = 2016-2017, n = 12,924). The age and sex standardised rate of hip fracture surgery and the proportion of patients with seven process quality indicators, three surgery types and four outcomes were calculated. Systematic components of variation (SCV) were calculated based on hospital area (6 Irish hospital groups, 5 Danish regions).

resultsThe age and sex standardised rate of hip fracture surgery per 1000 older population in 2017 was 4.7 (95% CI = 4.4-5.1) in Ireland and 5.3 (95% CI = 5.1-5.5) in Denmark. Ireland had lower rates of surgery within 36 h (59% versus 84%), nutritional assessment (27% versus 84%) and pre-discharge mobility recording (52% versus 92%). Patterns of intracapsular fracture repair also differed between countries (hemiarthroplasty: Ireland = 85%, Denmark = 52%). Both countries had very high variation for total hip arthroplasty (THA) provision (SCV Ireland = 10.6, Denmark = 97.9). Ireland had longer hospital stays (median 12 versus 7 days), but lower 7-day (1.0% versus 3.1%) and 14-day (2.0% versus 5.5%) mortality.

conclusionIreland and Denmark have similar hip fracture surgery rates, but differences in care quality, surgery patterns and outcomes. High variation in THA provision and observed differences in mortality require further exploration. In Ireland, there is scope for improvement regarding early surgery, mobility, nutrition assessment and improved post-discharge follow-up.

Indexed as

AftercareHip FracturesDenmarkHumansIrelandPatient DischargeRegistriesRisk FactorsFemoral fractureGeographic variationHip fractureMortalityQuality of health care

Identifiers

PMID36161538

What OpenQuestion holds

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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.