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"IMSS Multicenter Hip Fracture Registry Report: 2024"
Duarte-Flores José Octavio1, Cortez-Sarabia Joel Alonso2, Sánchez-García Sergio3
1Geriatric Service of the HGZ 83 IMSS, Morelia, Mexico. dr.duarte.geriatra86@gmail.com.
Abstract:
The IMSS 2024 multicenter hip fracture (HF) registry showed an in-hospital mortality rate of 2.6% and an emergency department stay of 24 h (IQR 9-47); however, critical challenges persist, such as low surgical goal completion within 36 h (8.6%) and high post-discharge follow-up loss (70.6% at 30 days). Report of the Multicenter Hip Fracture Registry of the Instituto Mexicano del Seguro Social (IMSS): 2024.
Background:
Hip fracture (HF) is a major cause of morbidity and mortality that entails high costs for the healthcare system. The number of cases will increase in the coming years.
Objectives:
To describe the standards of care for HF in multiple IMSS hospitals.
Methods:
An observational, multicenter, longitudinal, and descriptive study was carried out. Twenty hospitals in Mexico were included. Data were recorded on hospital stay, epidemiological data, and management, with follow-up at 30 and 120 days after discharge. The data was analyzed using SPSS version 22.0.
Results:
A total of 1,095 subjects participated, with a median age of 79 years (IQR 74-85), predominantly women (n = 786; 71.8%) from the community (n = 1009; 92.1%), autonomous (Barthel 90 points IQR 75-100). The mean time to transfer to the emergency department was 88.2 ± 197 h. Pertrochanteric type HF was the most frequent (n = 573, 52.3%). Thromboprophylaxis was given in 84.8% (n = 929) and antibiotic prophylaxis in 50.7% (n = 555). The goal of 36 h for the surgical procedure was achieved in 8.6% of subjects (n = 94), with the most frequent cause of delay being delay in scheduling (n = 824, 75.3%). The mean time from emergency room to surgical procedure was 6.6 ± 6.3 days. Acute mortality was 2.6% (n = 28). Secondary prevention at discharge occurred in 65.3% (n = 715) of subjects. At 30 days, 754 subjects (70.6%) were lost to follow-up and were discharged with a mortality rate of 7.6% (n = 24), while at 120 days, 87 subjects (30.1%) who had been assessed at 30 days were lost, with a mortality rate of 7.4% (n = 15).
Conclusion:
There was a slight improvement in the standards of care in HF compared to last year; however, improvements are required in specific areas.