Differences in Hip Fracture Care in Europe: a Systematic Review of Recent Annual Reports of Hip Fracture Registries

Overview

Journal Eur J Trauma Emerg Surg

Specialties Critical Care
Emergency Medicine

Date 2021 Oct 8

PMID 34623474

Citations 20

Authors

Maic Werner

Christian Macke

Manfred Gogol

Christian Krettek

Emmanouil Liodakis

Affiliations

Soon will be listed here.

Abstract

Purpose: Hip fractures are of growing interest due to their increasing number, subsequent functional decline and high institutionalization rate of patients, mortality, and costs. Several process measurements are essential for hip fracture care. To compare and improve these, hip fracture registries in Europe became popular. This systematic review aims to describe the differences between hip fracture registries in Europe as well as the differences in hip fracture treatment between countries.

Methods: A systematic search using the keywords "hip fracture" AND "national" AND "database OR audit OR registry OR register" was performed in PubMed, Embase and Cochrane Library according to PRISMA guidelines till 3rd December 2020. Recent annual reports of identified hip fracture registries in Europe were additionally identified in June 2021. Comparisons of most common case-mix, process and outcome measurements were performed.

Results: 11 registries in Europe were identified. Differences were observed regarding inclusion criteria of the different registries. Comparison of the different registries was difficult due to differences in the way to report measurements. While mortality rates differed substantially between countries, most of the process measurements met recommendations according to recent guidelines.

Conclusion: Hip fracture registries were a valid tool to compare hospitals within one country. However, a comparison between registries of different countries should have also been easily possible. For this, the registries need to make their data easily accessible and further unify their way of measuring and reporting.

Citing Articles

Which performance indicators are used globally for evaluating healthcare in patients with a hip fracture? : a mixed methods systematic review.

Mazarello Paes V, Ting A, Masters J, Paes M, Tutton E, Graham S Bone Jt Open. 2025; 6(3):275-290.

PMID: 40043739 PMC: 11882308. DOI: 10.1302/2633-1462.63.BJO-2024-0104.R1.

Defining optimal orthogeriatric hip fracture care: a delphi consensus approach.

van Bremen H, Seppala L, Gans E, Hegeman J, van der Velde N, Willems H Eur Geriatr Med. 2025; .

PMID: 39909977 DOI: 10.1007/s41999-025-01156-5.

The Impact of National Orthopaedic Fracture Registries: A Systematic Review.

Jozefowski N, Eikani C, Lingampalli N, Lawler P, Barrett A, Hoyt A OTA Int. 2025; 8(1):e361.

PMID: 39901920 PMC: 11789904. DOI: 10.1097/OI9.0000000000000361.

Delirium and Cognitive Screening in National Hip Fracture Registries: Scoping Review Protocol.

Merriman N, Penfold R, Brent L, Hickey P, Walsh M, Sexton E HRB Open Res. 2025; 7:68.

PMID: 39877697 PMC: 11773136. DOI: 10.12688/hrbopenres.13996.2.

Proximal Femur Fractures: Evaluating the Necessity of On-Call Surgery.

Ketter V, Korschinsky A, Bokeler U, Aigner R, Bucking B, Eschbach D J Clin Med. 2025; 14(1.

PMID: 39797175 PMC: 11721314. DOI: 10.3390/jcm14010093.

References

Leal J, Gray A, Prieto-Alhambra D, Arden N, Cooper C, Javaid M . Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int. 2015; 27(2):549-58. PMC: 4740562. DOI: 10.1007/s00198-015-3277-9. View

Butt F, Hussain A, Mushtaq Khan A, Sultan M . Implants For Extracapsular Neck Of Femur Fracture Dynamic Hip Screw Versus Intramedullary Nailing. J Ayub Med Coll Abbottabad. 2018; 29(4):697-701. View

Fox K, Magaziner J, Hebel J, Kenzora J, Kashner T . Intertrochanteric versus femoral neck hip fractures: differential characteristics, treatment, and sequelae. J Gerontol A Biol Sci Med Sci. 2000; 54(12):M635-40. DOI: 10.1093/gerona/54.12.m635. View

Pincus D, Ravi B, Wasserstein D, Huang A, Paterson J, Nathens A . Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery. JAMA. 2017; 318(20):1994-2003. PMC: 5820694. DOI: 10.1001/jama.2017.17606. View

Zhang K, Zhang S, Yang J, Dong W, Wang S, Cheng Y . Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: a meta-analysis. Med Sci Monit. 2014; 20:1628-33. PMC: 4170652. DOI: 10.12659/MSM.890962. View

Sterling R . Gender and race/ethnicity differences in hip fracture incidence, morbidity, mortality, and function. Clin Orthop Relat Res. 2010; 469(7):1913-8. PMC: 3111795. DOI: 10.1007/s11999-010-1736-3. View

Slobogean G, Giannoudis P, Frihagen F, Forte M, Morshed S, Bhandari M . Bigger Data, Bigger Problems. J Orthop Trauma. 2015; 29 Suppl 12:S43-6. DOI: 10.1097/BOT.0000000000000463. View

Hu F, Jiang C, Shen J, Tang P, Wang Y . Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2011; 43(6):676-85. DOI: 10.1016/j.injury.2011.05.017. View

Voeten S, van Bodegom-Vos L, Hegeman J, Wouters M, Krijnen P, Schipper I . Hospital staff participation in a national hip fracture audit: facilitators and barriers. Arch Osteoporos. 2019; 14(1):110. PMC: 6872508. DOI: 10.1007/s11657-019-0652-8. View

10.

Ilango S, Pulle R, Bell J, Kuys S . General versus spinal anaesthesia and postoperative delirium in an orthogeriatric population. Australas J Ageing. 2015; 35(1):42-7. DOI: 10.1111/ajag.12212. View

11.

Dhanwal D, Dennison E, Harvey N, Cooper C . Epidemiology of hip fracture: Worldwide geographic variation. Indian J Orthop. 2011; 45(1):15-22. PMC: 3004072. DOI: 10.4103/0019-5413.73656. View

12.

Kowark A, Adam C, Ahrens J, Bajbouj M, Bollheimer C, Borowski M . Improve hip fracture outcome in the elderly patient (iHOPE): a study protocol for a pragmatic, multicentre randomised controlled trial to test the efficacy of spinal versus general anaesthesia. BMJ Open. 2018; 8(10):e023609. PMC: 6196806. DOI: 10.1136/bmjopen-2018-023609. View

13.

Moyet J, Deschasse G, Marquant B, Mertl P, Bloch F . Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice. Int Orthop. 2018; 43(6):1449-1454. DOI: 10.1007/s00264-018-3928-5. View

14.

Cucic S . European Union health policy and its implications for national convergence. Int J Qual Health Care. 2000; 12(3):217-25. DOI: 10.1093/intqhc/12.3.217. View

15.

Gullberg B, Johnell O, Kanis J . World-wide projections for hip fracture. Osteoporos Int. 1997; 7(5):407-13. DOI: 10.1007/pl00004148. View

16.

Edwards G, Metcalfe A, Johansen A, ODoherty D . Performance monitoring in hip fracture surgery--how big a database do we really need?. Injury. 2009; 41(4):374-6. DOI: 10.1016/j.injury.2009.10.006. View

17.

Kristensen P, Rock N, Christensen H, Pedersen A . The Danish Multidisciplinary Hip Fracture Registry 13-Year Results from a Population-Based Cohort of Hip Fracture Patients. Clin Epidemiol. 2020; 12:9-21. PMC: 6959215. DOI: 10.2147/CLEP.S231578. View

18.

Guay J, Parker M, Gajendragadkar P, Kopp S . Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2016; 2:CD000521. PMC: 6464323. DOI: 10.1002/14651858.CD000521.pub3. View

19.

Muhm M, Amann M, Hofmann A, Ruffing T . [Changes in the patient population with proximal femur fractures over the last decade : Incidence, age, comorbidities, and length of stay]. Unfallchirurg. 2017; 121(8):649-656. DOI: 10.1007/s00113-017-0425-z. View

20.

Cundall-Curry D, Lawrence J, Fountain D, Gooding C . Data errors in the National Hip Fracture Database: a local validation study. Bone Joint J. 2016; 98-B(10):1406-1409. DOI: 10.1302/0301-620X.98B10.37089. View