Hip fracture management and outcomes in Spain

BackgroundHip fracture (HF) is associated with high mortality and disability rates in the elderly over the world. The aim of this study is to describe how a patient with this condition will usually be managed in Spain.MethodsA general description of the most frequent practices in Spain in the treatment of HF in the elderly is performed. The organization of the Ortho-Geriatric Unit in the Hospital General Universitario “Gregorio Marañón” in Madrid is described. A brief revision of cross-nationally analysis of costs is presented.ResultsMany differences are seen in HF management between Autonomous Regions. The annual incidence of HF in the elderly is 511 per 100 000. Mean length of stay in the acute-care hospital is 15 days with a crude rate of in-hospital mortality of 5.3%. The model of care differs among hospitals, from consulting a geriatrician to the development of Ortho-Geriatric Units. The Ortho-Geriatric Unit in the “Gregorio Marañón” Hospital, with 500 patients admitted each year, includes the standardized treatment of the acute and rehabilitation phase and after-discharge outcomes and the result is a reduction in the in-hospital mortality rate or major complications.ConclusionsHF management in Spain is very heterogeneous because of our regional-based Health Care System. Probably, Ortho-Geriatric Units will be implemented in the future in many hospitals in Spain. To standardize the process of care in such units, by following international guidelines, will let us make comparisons between hospitals with similar characteristics.