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BMJ Open. 2017 May 4;7(4):e015368. doi: 10.1136/bmjopen-2016-015368.

Feasibility of administrative data for studying complications after hip fracture surgery.

Author information

1
Department of Physiotherapy, Division of Health and Social Care, Kings College, London, UK.
2
School of Population & Public Health, University of British Columbia, Vancouver, Canada.
3
Department of Orthopedics, University of British Columbia, Vancouver, Canada.
4
Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada.
5
Department of Orthopaedic surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Cente, El Paso, Texas, USA.
6
Decision Support, Vancouver Coastal Health Authority, Vancouver, Canada.
7
Department of Medicine, McGill University, Montreal, Canada.
8
Departments of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, Canada.
9
Department of Physical Therapy, University of Toronto, Toronto, Canada.
10
Division of Orthopaedic Surgery and Center for Healthcare Innovation, University of Manitoba, Winnipeg, Canada.
11
Department of Physical Therapy and the Division of Orthopaedic Surgery, University of Alberta, Edmonton, Canada.

Abstract

PURPOSE:

There is limited information in administrative databases on the occurrence of serious but treatable complications after hip fracture surgery. This study sought to determine the feasibility of identifying the occurrence of serious but treatable complications after hip fracture surgery from discharge abstracts by applying the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator 4 (PSI-4) case-finding tool.

METHODS:

We obtained Canadian Institute for Health Information discharge abstracts for patients 65 years or older, who were surgically treated for non-pathological first hip fracture between 1 January 2004 and 31 December 2012 in Canada, except for Quebec. We applied specifications of AHRQ Patient Safety Indicators 04, Version 5.0 to identify complications from hip fracture discharge abstracts.

RESULTS:

Out of 153 613 patients admitted with hip fracture, we identified 12 383 (8.1%) patients with at least one postsurgical complication. From patients with postsurgical complications, we identified 3066 (24.8%) patient admissions to intensive care unit. Overall, 7487 (4.9%) patients developed pneumonia, 1664 (1.1%) developed shock/myocardial infarction, 651 (0.4%) developed sepsis, 1862 (1.1%) developed deep venous thrombosis/pulmonary embolism and 1919 (1.3%) developed gastrointestinal haemorrhage/acute ulcer.

CONCLUSIONS:

We report that 8.1% of patients developed at least one inhospital complication after hip fracture surgery in Canada between 2004 and 2012. The AHRQ PSI-4 case-finding tool can be considered to identify these serious complications for evaluation of postsurgical care after hip fracture.

KEYWORDS:

Hip fracture; complications; patient safety indicators; surgery

PMID:
28473519
PMCID:
PMC5623359
DOI:
10.1136/bmjopen-2016-015368
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Competing interests: The authors declare that (1) BS, PG and the Collaborative have received grants from the Canadian Institutes of Health Research related to this work. (2) PG also receives funding from the Natural Sciences and Engineering Research Council of Canada, the Canadian Foundation for Innovation and the British Columbia Specialists Services Committee for work around hip fracture care not related to this manuscript. He has also received fees from the BC Specialists Services Committee (for a provincial quality improvement project on redesign of hip fracture care) and from Stryker Orthopedics (as a product development consultant). He is a board member and shareholder in Traumis Surgical Systems Inc. and a board member for the Canadian Orthopedic Foundation. He also serves on the speakers’ bureaus of AO Trauma North America and Stryker Canada. (3)SNM reports research grants from Amgen Canada, and from Merck, personal fees from Amgen Canada outside the submitted work. (4) KJS is a postdoctoral fellow whose salary is paid by Canadian Institutes of Health Research funding related to this work.

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