This review aimed to describe the methods and results from recent Irish research about post-acute hip fracture outcomes. Meta-analyses estimate the 30-day and 1-year mortality rate at 5% and 24% respectively. There is a need for standardised recommendations about which data should be recorded to aid national and international comparisons.
Purpose: Over 3700 older adults experience hip fracture in Ireland annually. The Irish Hip Fracture Database national audit records acute hospital data but lacks longer-term outcomes. This systematic review aimed to summarise and appraise recent Irish studies that collected long-term hip fracture outcomes and to generate pooled estimates where appropriate.
Methods: Electronic databases and grey literature were searched in April 2022 for articles, abstracts, and theses published from 2005 to 2022. Eligible studies were appraised by two authors and outcome collection details summarised. Meta-analyses of studies with common outcomes were conducted where the sample was generalisable to the broad hip fracture population.
Results: In total, 84 studies were identified from 20 clinical sites. Outcomes commonly recorded were mortality (n = 48 studies; 57%), function (n = 24; 29%), residence (n = 20; 24%), bone-related outcomes (n = 20; 24%), and mobility (n = 17; 20%). One year post-fracture was the most frequent time point, and patient telephone contact was the most common collection method used. Most studies did not report follow-up rates. Two meta-analyses were performed. The pooled estimate for one-year mortality was 24.2% (95% CI = 19.1-29.8%, I2 = 93.8%, n = 12 studies, n = 4220 patients), and for 30-day mortality was 4.7% (95% CI = 3.6-5.9%, I2 = 31.3%, n = 7 studies, n = 2092 patients). Reports of non-mortality outcomes were deemed inappropriate for meta-analysis.
Conclusion: Hip fracture long-term outcomes collected in Irish research are broadly in line with international recommendations. Heterogeneity of measures and poor reporting of methods and findings limits collation of results. Recommendations for standard outcome definitions nationally are warranted. Further research should explore the feasibility of recording long-term outcomes during routine hip fracture care in Ireland to enhance national audit.
Mary E Walsh, Caitriona Cunningham, Louise Brent, Bibiana Savin, Michelle Fitzgerald, Catherine Blake
Disease Category: Wounds
Disease Name: Hip fracture
Age Range: Unknown
Sex: Either
Nature of Intervention: Not specified
- Systematic review of outcomes measured in trials
- Systematic review
Traditional and grey literature sources were searched in July 2021, and the search was updated in April 2022. Electronic databases searched included MEDLINE (Ovid), Embase,
Scopus, Web of Science, CINAHL, and ProQuest Dissertations and Theses. Specific Irish research repositories were also searched (www.rian.ie and www.lenus.ie). This was
supplemented by an advanced Google search of specific Irish governmental and health-system websites. Ongoing and unpublished research was sought through websites of national funding organisations and trial registries. Email contact was made with programme leads for 25 taught masters programmes across all major academic institutions that
were likely to have supervised relevant research spanning the subjects of surgery, nursing, and rehabilitation. Finally, publicly available abstract books from key conferences in
the areas of gerontology, orthopaedics, and rheumatology were hand-searched if not indexed in databases