Hip fractures in Spain. How are we? Systematic review and meta-analysis of the published registries.

Abstract

Objective: Spain is expected to be the country with the highest life expectancy in the coming years. In this context, it is important to improve the care of hip fractures. The objective of this work was to describe the results of the registries published on hip fractures in Spain.

Material and methods: Systematic review and meta-analysis of the records published on hip fractures in Spain, the last 10 years. The characteristics of the study, characteristics of the patients, of the fractures, the type of surgery, as well as morbidity and mortality were analyzed.

Results: A total of 55,680 patients with a mean age of 84.6 years were analyzed, of whom 75% were women. Extracapsular fractures were the most frequent (58%). It was found that conservative treatment was applied in an average of 3% of cases. The average surgical delay was 64.7hours, with a mean percentage of patients operated on within 24hours at 18%, and within 48hours at 40%. A mean hospitalization time of 10.7 days was found. Delirium was found to be the most frequent postoperative complication (42%). The mean transfusion rate was 36%. Mean in-hospital mortality at one month and one year was 4%, 5% and 18%, respectively.

Conclusions: Less than half of patients with a hip fracture undergo surgery within 48hours, despite being recommended by the majority of clinical practice guidelines. Delirium is the most frequently reported postoperative complication, and one in every 5 patients will die within a year after a hip fracture. Standardizing the management of hip fractures at the state level could improve healthcare quality and facilitate the establishment of common criteria for good clinical practice.