Comorbidity and Quality of In-Hospital Care for Hip Fracture Patients

• DOI: 10.1016/j.jamda.2022.01.078
• Publication Date: 2022-03-02T21:30:01Z
• Authors: Christine K. Schr...; Thomas J. Hjelholt; Henrik Møller; Morten Madsen; Alma B. Pedersen; Pia K. Kristensen
• Keywords: Hip Fracture

We examined whether the comorbidity burden of patients with hip fracture was associated quality in-hospital care reflected by fulfillment process performance measures.Population-based cohort study using prospectively collected data from Danish Multidisciplinary Hip Fracture Registry (DMHFR).Patients aged 65 years or older an incident 2014 to 2018 registered in DMHFR (n = 31,443).Comorbidity measured Charlson Comorbidity Index based on hospital diagnoses. Quality defined as eligible measures, including preoperative optimization, early surgery, mobilization, pain assessment, basic mobility, nutritional risk, need for anti-osteoporotic medication, fall prevention, and a post-discharge rehabilitation program, reflecting guideline-recommended care. The outcomes were (1) all-or-none composite measure all relevant (2) individual measures. Using binary regression, we calculated relative risk (RR) association between level outcomes.The overall proportion who fulfilled 31%. Among no comorbidity, 34% versus 29% among high (Charlson ≥ 3). This corresponds 15% lower chance (RR 0.85, 95% confidence interval 0.81-0.89). Increasing also largest difference seen where had 6% 11% these measures compared without comorbidity.Increasing fracture. Our results highlight tailored clinical initiatives ensure that comorbid benefit positive progress recent years.