A5082532574- Hip and Femur Fractures
- Cardiac, Anesthesia and Surgical Outcomes
- Bone health and osteoporosis research
- Trauma and Emergency Care Studies
- Emergency and Acute Care Studies
- Chronic Disease Management Strategies
- Pelvic and Acetabular Injuries
- Primary Care and Health Outcomes
- Nursing Roles and Practices
- Venous Thromboembolism Diagnosis and Management
- Frailty in Older Adults
- Bone fractures and treatments
- Intensive Care Unit Cognitive Disorders
- Healthcare cost, quality, practices
- Orthopaedic implants and arthroplasty
- Shoulder and Clavicle Injuries
- Injury Epidemiology and Prevention
- Geriatric Care and Nursing Homes
- Healthcare Systems and Public Health
- Atrial Fibrillation Management and Outcomes
- Vitamin D Research Studies
- Anesthesia and Pain Management
- Health disparities and outcomes
- Clinical practice guidelines implementation
- Hip disorders and treatments
University Hospital of Wales
2015-2025
Cardiff University
2009-2025
Royal College of Physicians
2015-2025
National Marrow Donor Program
2021-2024
Cardiff and Vale University Health Board
2006-2023
Royal Children's Hospital
2010-2023
Royal Devon & Exeter NHS Foundation Trust
2023
James Cook University Hospital
2023
Princess Elizabeth Orthopaedic Centre
2023
University of Bristol
2023
To identify participants' characteristics that influence the anti-fracture efficacy of vitamin D or plus calcium with respect to any fracture, hip and clinical vertebral fracture assess dosing regimens co-administration calcium.Individual patient data analysis using pooled from randomised trials.Seven major trials alone, yielding a total 68 517 participants (mean age 69.9 years, range 47-107 14.7% men).Studies included were studies at least one intervention arm in which was given, as an...
hip fracture is expensive in terms of mortality, hospital length stay (LOS) and consequences for independence. Poor outcome reflects the vulnerability patients who typically sustain this injury, but impact different comorbidities impairments complex to understand. We consider a prospective cohort study designed examine how patients' frailty index (FI) predicts outcome.consecutive with low trauma were assessed, excluding only those unfit surgery. Comprehensive Geriatric Assessment (CGA)...
To examine how improved attention to nutritional status and dietary intake, achieved through the employment of dietetic assistants (DAs), will affect postoperative clinical outcome among elderly women with hip fracture.Open prospective randomised controlled trial, comparing conventional nursing care additional support provided by DA.Thirty-eight bedded acute trauma ward in a teaching hospital.All but 11 344 consecutive admissions nonpathological fracture were approached. Three hundred...
We re-analysed prospective data collected by anaesthetists in the Anaesthesia Sprint Audit of Practice (ASAP 1) order to describe associations with linked outcome data.Mortality was 165/11,085 (1.5%) 5 days and 563/11,085 (5.1%) 30 after surgery not associated anaesthetic technique (general vs spinal, or without peripheral nerve blockade).The risk death increased as blood pressure fell: odds ratio (95% CI) for mortality within 0.983 (0.973-0.994) each mmHg intra-operative increment systolic...
SUMMARYThe prevalence of osteoporosis increases with age. The over-50-year-old population is expected to grow by 10% and 25% 2010 2020, respectively. There are already 3 million UK residents the public health impact will increase substantially over next 20 years. A Markov model natural history was used predict fracture numbers corresponding costs for aged 50-99 from 2000 2020. predicts 190,000 osteoporosis-related fractures at a cost £1.8 billion in 2000. By annual osteoporotic 21% 230,000...
Background: multidisciplinary rehabilitation is of proven benefit in the management older inpatients. However, identification patients who will do well with currently lacks a strong evidence base.
Concise guidelines are presented for the preparation and conduct of anaesthesia surgery in patients undergoing cemented hemiarthroplasty hip fracture. The Working Party specifically considered recent publications highlighting complications occurring during peri-operative period 1, 2. advice is based on previously published clinical studies.
Summary Hip fracture is the most common reason for older patients to need emergency anaesthesia and surgery. Up one‐third of die in year after hip fracture, but this view outcome may encourage therapeutic nihilism peri‐operative decisions discussions. We used a multicentre national dataset examine relative absolute mortality rates presenting with stratified by ASA physical status. analysed status, dates surgery, death hospital discharge 59,369 out 64,864 2015 National Fracture Database; 3914...
The aim of this study was to explore current use the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and propose a revised MCD enable international benchmarking for care.We compared all ten registries: England, Wales, Northern Ireland; Scotland; Australia New Zealand; Republic Germany; Netherlands; Sweden; Norway; Denmark; Spain. We tabulated questions included in each registry, cross-referenced them against 32...
The National Hip Fracture Database (NHFD) publishes hospital-level risk-adjusted mortality rates following hip fracture surgery in England, Wales and Northern Ireland. performance of the risk model used by NHFD was compared with widely-used Nottingham Score.Data from 94 hospitals on patients aged 60 to 110 who had between May 2013 July were analysed. Data linked Office for Statistics (ONS) death register calculate 30-day rate. Risk predicted each patient using models a development dataset...
to describe the increase in orthogeriatrician involvement hip fracture care England and its association with improvements time surgery mortality.analysis of Hospital Episode Statistics for 196,401 patients presenting 150 hospitals between 1 April 2010 28 February 2014, combined data on hours from a national organisational survey.we examined changes average number worked by orthogeriatricians orthopaedic departments per patient fracture, their potential effect mortality within 30 days...
Hip fracture care delivery varies between hospitals, which might explain variations in patient outcomes and health costs. The aim of this study was to identify hospital-level organisational factors associated with long-term costs after hip fracture.REDUCE a record-linkage cohort national databases for all patients aged 60 years older who sustained England Wales were linked hospital metrics from 18 data sources. Multilevel models identified the case-mix adjusted primary outcomes: cumulative...
Abstract Objectives Despite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes months following fracture. Methods examined a national record-linkage cohort 178,757 patients aged ≥60 years who sustained England Wales 2016–19. Patient-level hospital admissions datasets, National Hip Fracture Database mortality data were...
To determine the relationship between three postoperative physiotherapy activities (time to first walk, activity on day after surgery, and frequency), outcomes of hospital length stay (LOS) discharge destination hip fracture.
<ns3:p>Background Delirium and cognitive impairment are common in hip fracture populations associated with significant adverse patient outcomes. National registries facilitate improvements outcomes care quality, such as reduced mortality the development of specialist multidisciplinary services. However, there is substantial variation data collected reported relation to delirium cognition, which impedes international comparison may reduce quality care. Objective This scoping review aims...
The aim of this study was to evaluate the suitability, against an accepted international standard, a linked hip fracture registry and routinely collected administrative dataset in England embed deliver randomized controlled trials (RCTs). First, bespoke cohort individuals sustaining fractures between 2011 2016 generated from National Hip Fracture Database (NHFD) individual Hospital Episode Statistics (HES) records mortality data. Second, order explore availability distribution outcomes...
Aims Delirium is common in hip fracture patients, but large-scale routine data studies examining the prevalence and associations of delirium at time initial presentation with a are rare. This study aimed to describe outcomes on large national population sample. Methods analyzed routinely collected clinical registry for all people Scotland aged 50 years over presenting between 1 July 2019 31 December 2021. was assessed prospectively by clinicians as part care using 4AT, validated two-minute...