[On the prognosis of hip fractures. Assessment of mortality after hip fractures by analyzing overlapping segments of longitudinal data].
BACKGROUND
Data on the treatment of hip fractures in acute care settings have been collected in a report card system for quality assurance in Germany since the beginning of the 1990s. However, there are no data on the long-term outcome and long-term quality of care.


METHODS
In a retrospective study, data on 1393 patients from 1999 were collected from different sources: from the department of quality assurance at the medical association of Westfalia-Lippe, the Statutory Health Insurance Funds (AOK), and the Medical Review Board of the Statutory Health Insurance Funds (Medizinischer Dienst der Krankenkasse, MDK). Statistical analyses were performed by the Center for Clinical Studies of the University of Düsseldorf.


RESULTS
Uni- and multivariate analyses reveal the following prognostic parameters for survival after hip fracture: sex, age, nursing care dependency, living in a nursing home, risk stratification according to ASA, and postoperative complications. Timing of the operation had no affect on survival.


CONCLUSIONS
Prognostic factors for the outcome after hip fracture can only be obtained by analyzing data from the hospital stay and the post-hospital setting as well. Chances of survival can be significantly improved by rehabilitative care.
Smektala
R
R
Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum-Langendreer, Universitätsklinik der Ruhr-Universität, Bochum. ruediger.smektala@ruhr-uni-bochum.de
Ohmann
C
C
Paech
S
S
Neuhaus
E
E
Rieger
M
M
Schwabe
W
W
Debold
P
P
Deimling
A
A
Jonas
M
M
Hupe
K
K
Bücker-Nott
H J
HJ
Giani
G
G
Szucs
T D
TD
Pientka
L
L
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate