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Preventable mortality in geriatric hip fracture inpatients

机译:老年髋部骨折患者的可预防死亡率

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There is a high rate of mortality in elderly patients who sustain a fracture of the hip. We aimed to determine the rate of preventable mortality and errors during the management of these patients. A 12 month prospective study was performed on patients aged > 65 years who had sustained a fracture of the hip. This was conducted at a Level 1 Trauma Centre with no orthogeriatric service. A multidisciplinary review of the medical records by four specialists was performed to analyse errors of management and elements of preventable mortality. During 2011, there were 437 patients aged > 65 years admitted with a fracture of the hip (85 years (66 to 99)) and 20 died while in hospital (86.3 years (67 to 96)). A total of 152 errors were identified in the 80 individual reviews of the 20 deaths. A total of 99 errors (65%) were thought to have at least a moderate effect on death; 45 reviews considering death (57%) were thought to have potentially been preventable. Agreement between the panel of reviewers on the preventability of death was fair. A larger-scale assessment of preventable mortality in elderly patients who sustain a fracture of the hip is required. Multidisciplinary review panels could be considered as part of the quality assurance process in the management of these patients.
机译:患有髋部骨折的老年患者死亡率很高。我们旨在确定这些患者在治疗过程中可预防的死亡率和错误率。对年龄大于65岁且髋部骨折的患者进行了为期12个月的前瞻性研究。这是在没有骨科服务的1级创伤中心进行的。由四位专家对病历进行了多学科审查,以分析管理错误和可预防的死亡因素。 2011年期间,有437名年龄在65岁以上的患者因髋部骨折入院(85岁(66至99岁)),其中20例在住院期间死亡(86.3岁(67至96岁))。在对20例死亡的80次个人检查中,总共发现152个错误。总共有99个错误(65%)被认为对死亡至少具有中等程度的影响;有45篇考虑死亡的评论(占57%)被认为是可以预防的。审查小组之间就死亡的可预防性达成的协议是公平的。需要对维持髋部骨折的老年患者进行可预防性死亡的大规模评估。在这些患者的治疗中,多学科审查小组可被视为质量保证过程的一部分。
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