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Quality and Safety

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Proximal Femur Fractures

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Abstract

Fractures of the proximal femur in elderly patients represent a significant burden on society for a number of reasons. The worldwide population is aging at an increasing rate, and with age, the rate of fragility fractures, including fractures about the hip, increases in prevalence. The morbidity and mortality associated with hip fractures is derived from a number of different factors that affect the diagnosis, treatment, and overall care of patients who sustain these injuries. In order to optimize patient outcomes, minimize health-care costs, and decrease the burden of disease associated with these injuries, it is important to understand all of the various factors that play a role in shaping the natural history, pathophysiology, and treatment strategies. This chapter will summarize the recent literature and evidence-based recommendations pertaining to the overall care of patients who present to the hospital with a hip fracture or are at risk of sustaining a hip fracture, to assist any health-care provider involved in the management of these patients in providing the best care possible.

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References

  1. Cutler D, Wikler E, Basch P. Reducing administrative costs and improving the health care system. N Engl J Med. 2012;367:1875–8.

    Article  CAS  PubMed  Google Scholar 

  2. Mears SC, Kates SL. A guide to improving the care of patients with fragility fractures. Geriatr Orthop Surg Rehabil. 2015;6:58–120.

    Article  PubMed  PubMed Central  Google Scholar 

  3. AHRQ. 2012 HCUP nationwide inpatient sample (NIS) report. Rockville: Agency for Healthcare Research and Quality. p. 2012.

    Google Scholar 

  4. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22:465–75.

    Article  PubMed  Google Scholar 

  5. Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH. Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am. 1995;77:1551–6.

    Article  CAS  PubMed  Google Scholar 

  6. Ettinger B, Black DM, Dawson-Hughes B, Pressman AR, Melton LJ. Updated fracture incidence rates for the US version of FRAX. Osteoporos Int. 2010;21:25–33.

    Article  CAS  PubMed  Google Scholar 

  7. Sathiyakumar V, Avilucea FR, Whiting PS, Jahangir AA, Mir HR, Obremskey WT, et al. Risk factors for adverse cardiac events in hip fracture patients: an analysis of NSQIP data. Int Orthop. 2015;40:439–45.

    Article  PubMed  Google Scholar 

  8. Magaziner J, Fredman L, Hawkes W, Hebel JR, Zimmerman S, Orwig DL, et al. Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community-dwelling aged. Am J Epidemiol. 2003;157:1023–31.

    Article  PubMed  Google Scholar 

  9. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ. Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury. 2008;39:1157–63.

    Article  CAS  PubMed  Google Scholar 

  10. Diamantopoulos AP, Hoff M, Skoie IM, Hochberg M, Haugeberg G. Short- and long-term mortality in males and females with fragility hip fracture in Norway. A population-based study. Clin Interv Aging. 2013;8:817–23.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of a comanaged geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med. 2009;169:1712–7.

    Article  PubMed  Google Scholar 

  12. Mears SC, Pantle HA, Bessman ES, Lifchez SD. Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries. Orthopaedics. 2015;38:e407–10.

    Article  Google Scholar 

  13. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc. 2001;49:516–22.

    Article  CAS  PubMed  Google Scholar 

  14. Miura LN, DiPiero AR, Homer LD. Effects of a geriatrician-led hip fracture program: improvements in clinical and economic outcomes. J Am Geriatr Soc. 2009;57:159–67.

    Article  PubMed  Google Scholar 

  15. Friedman SM, Mendelson DA, Kates SL, McCann RM. Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc. 2008;56:1349–56.

    Article  PubMed  Google Scholar 

  16. Kates SL, Mendelson DA, Friedman SM. Co-managed care for fragility hip fractures (Rochester model). Osteoporos Int. 2010;21:S621–5.

    Article  CAS  PubMed  Google Scholar 

  17. Khan SK, Kalra S, Khanna A, Thiruvengada MM, Parker MJ. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury. 2009;40(7):692.

    Article  PubMed  Google Scholar 

  18. Simunovic N, Devereaux PJ, Sprague S, Guyatt GH, Schemitsch E, Debeer J, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010;182:1609–16.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Orosz GM, Magaziner J, Hannan EL, Morrison RS, Koval K, Gilbert M, et al. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004;291:1738–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Kamel HK, Iqbal MA, Mogallapu R, Maas D, Hoffmann RG. Time to ambulation after hip fracture surgery: relation to hospitalization outcomes. J Gerontol A Biol Sci Med Sci. 2003;58:1042–5.

    Article  PubMed  Google Scholar 

  21. Clague JE, Craddock E, Andrew G, Horan MA, Pendleton N. Predictors of outcome following hip fracture. Admission time predicts length of stay and in-hospital mortality. Injury. 2002;33:1–6.

    Article  PubMed  Google Scholar 

  22. AAOS. Management of hip fractures in the elderly. 2014 ed. AAOS, Rosemont; 2014. p. 17.

    Google Scholar 

  23. Giusti A, Barone A, Razzano M, Pizzonia M, Pioli G. Optimal setting and care organization in the management of older adults with hip fracture. Eur J Phys Rehabil Med. 2011;47:281–96.

    CAS  PubMed  Google Scholar 

  24. Coleman EA, Kramer AM, Kowalsky JC, Eckhoff D, Lin M, Hester EJ, et al. A comparison of functional outcomes after hip fracture in group/staff HMOs and fee-for-service systems. Eff Clin Pract. 2000;3:229–39.

    CAS  PubMed  Google Scholar 

  25. Grigoryan KV, Javedan H, Rudolph JL. Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis. J Orthop Trauma. 2014;28:e49–55.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kates SL, Behrend C, Mendelson DA, Cram P, Friedman SM. Hospital readmission after hip fracture. Arch Orthop Trauma Surg. 2015;135:329–37.

    Article  PubMed  Google Scholar 

  27. Kates SL, Mendelson DA, Friedman SM. The value of an organized fracture program for the elderly: early results. J Orthop Trauma. 2011;25:233–7.

    Article  PubMed  Google Scholar 

  28. Kates SL, O'Malley N, Friedman SM, Mendelson DA. Barriers to implementation of an organized geriatric fracture program. Geriatr Orthop Surg Rehabil. 2012;3:8–16.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kates SL. Lean business model and implementation of a geriatric fracture center. Clin Geriatr Med. 2014;30(2):191–205.

    Article  PubMed  Google Scholar 

  30. Montalvo I. The national database of nursing quality indicators; 2007.

    Google Scholar 

  31. Gleason LJ, Mendelson DA, Kates SL, Friedman SM. Anticoagulation management in individuals with hip fracture. J Am Geriatr Soc. 2014;62(1):159–64.

    Article  PubMed  Google Scholar 

  32. Vitale MA, Vanbeek C, Spivack JH, Cheng B, Geller JA. Pharmacologic reversal of warfarin-associated coagulopathy in geriatric patients with hip fractures: a retrospective study of thromboembolic events, postoperative complications, and time to surgery. Geriatr Orthop Surg Rehabil. 2011;2:128–34.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Tharmarajah P, Pusey J, Keeling D, Willett K. Efficacy of warfarin reversal in orthopaedic trauma surgery patients. J Orthop Trauma. 2007;21:26–30.

    Article  PubMed  Google Scholar 

  34. Al-Rashid M, Parker MJ. Anticoagulation management in hip fracture patients on warfarin. Injury. 2005;36:1311–5.

    Article  PubMed  Google Scholar 

  35. Dunn AS, Spyropoulos AC, Turpie AG. Bridging therapy in patients on long-term oral anticoagulants who require surgery: the prospective peri-operative enoxaparin cohort trial (PROSPECT). J Thromb Haemost. 2007;5:2211–8.

    Article  CAS  PubMed  Google Scholar 

  36. Douketis JD. Anticoagulation therapy: perioperative anticoagulation-are we at ‘a bridge too far’? Nat Rev Cardiol. 2015;12:133–4.

    Article  PubMed  Google Scholar 

  37. Schulman S. Why is factor Xa not a better target than factor IIa for therapeutic inhibition of coagulation? Semin Thromb Hemost. 2003;29(Suppl 1):33–6.

    Article  CAS  PubMed  Google Scholar 

  38. Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;130:2215–45.

    Article  PubMed  Google Scholar 

  39. Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR, Rhoads GG, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365:2453–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Brunskill SJ, Millette SL, Shokoohi A, Pulford EC, Doree C, Murphy MF, et al. Red blood cell transfusion for people undergoing hip fracture surgery. Cochrane Database Syst Rev. 2015;4:CD009699.

    Google Scholar 

  41. Kumar D, Mbako AN, Riddick A, Patil S, Williams P. On admission haemoglobin in patients with hip fracture. Injury. 2011;42:167–70.

    Article  CAS  PubMed  Google Scholar 

  42. Wijeysundera DN, Duncan D, Nkonde-Price C, Virani SS, Washam JB, Fleischmann KE, et al. Perioperative beta blockade in noncardiac surgery: a systematic review for the 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64:2406–25.

    Article  PubMed  Google Scholar 

  43. Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2013;2:CD000567.

    Google Scholar 

  44. Neuman MD, Rosenbaum PR, Ludwig JM, Zubizarreta JR, Silber JH. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA. 2014;311:2508–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth. 2000;84:450–5.

    Article  CAS  PubMed  Google Scholar 

  46. Enneking FK, Chan V, Greger J, Hadzic A, Lang SA, Horlocker TT. Lower-extremity peripheral nerve blockade: essentials of our current understanding. Reg Anesth Pain Med. 2005;30:4–35.

    PubMed  Google Scholar 

  47. Luger TJ, Kammerlander C, Gosch M, Luger MF, Kammerlander-Knauer U, Roth T, et al. Neuroaxial versus general anaesthesia in geriatric patients for hip fracture surgery: does it matter? Osteoporos Int. 2010;21:S555–72.

    Article  CAS  PubMed  Google Scholar 

  48. Tarkkila PJ, Kaukinen S. Complications during spinal anesthesia: a prospective study. Reg Anesth. 1991;16:101–6.

    CAS  PubMed  Google Scholar 

  49. Hyderally H. Complications of spinal anesthesia. Mt Sinai J Med. 2002;69:55–6.

    PubMed  Google Scholar 

  50. Richman JM, Liu SS, Courpas G, Wong R, Rowlingson AJ, McGready J, et al. Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis. Anesth Analg. 2006;102:248–57.

    Article  PubMed  Google Scholar 

  51. Rashiq S, Vandermeer B, Abou-Setta AM, Beaupre LA, Jones CA, Dryden DM. Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: multiple treatment comparison. Can J Anaesth. 2013;60:230–43.

    Article  PubMed  Google Scholar 

  52. Parker MJ, Handoll HH, Griffiths R. Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2004;4:CD000521.

    Google Scholar 

  53. Parker MJ, Unwin SC, Handoll HH, Griffiths R. General versus spinal/epidural anaesthesia for surgery for hip fractures in adults. Cochrane Database Syst Rev. 2000;4:CD000521.

    Google Scholar 

  54. Halm EA, Wang JJ, Boockvar K, Penrod J, Silberzweig SB, Magaziner J, et al. The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture. J Orthop Trauma. 2004;18:369–74.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Morrison RS, Magaziner J, McLaughlin MA, Orosz G, Silberzweig SB, Koval KJ, et al. The impact of post-operative pain on outcomes following hip fracture. Pain. 2003;103:303–11.

    Article  PubMed  Google Scholar 

  56. Vaurio LE, Sands LP, Wang Y, Mullen EA, Leung JM. Postoperative delirium: the importance of pain and pain management. Anesth Analg. 2006;102:1267–73.

    Article  PubMed  Google Scholar 

  57. Fong HK, Sands LP, Leung JM. The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review. Anesth Analg. 2006;102:1255–66.

    Article  PubMed  Google Scholar 

  58. Grass JA. Patient-controlled analgesia. Anesth Analg. 2005;101:S44–61.

    Article  CAS  PubMed  Google Scholar 

  59. Stein C. The control of pain in peripheral tissue by opioids. N Engl J Med. 1995;332:1685–90.

    Article  CAS  PubMed  Google Scholar 

  60. Morrison RS, Magaziner J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76–81.

    Article  PubMed  Google Scholar 

  61. Abou-Setta AM, Beaupre LA, Rashiq S, Dryden DM, Hamm MP, Sadowski CA, et al. Comparative effectiveness of pain management interventions for hip fracture: a systematic review. Ann Intern Med. 2011;155:234–45.

    Article  PubMed  Google Scholar 

  62. Newman B, McCarthy L, Thomas PW, May P, Layzell M, Horn K. A comparison of pre-operative nerve stimulator-guided femoral nerve block and fascia iliaca compartment block in patients with a femoral neck fracture. Anaesthesia. 2013;68:899–903.

    Article  CAS  PubMed  Google Scholar 

  63. Elvir-Lazo OL, White PF. The role of multimodal analgesia in pain management after ambulatory surgery. Curr Opin Anaesthesiol. 2010;23:697–703.

    Article  PubMed  Google Scholar 

  64. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616–31.

    Article  Google Scholar 

  65. Shea JD. Pressure sores: classification and management. Clin Orthop Relat Res. 1975;112:89–100.

    Article  Google Scholar 

  66. Ek AC, Unosson M, Larsson J, Von Schenck H, Bjurulf P. The development and healing of pressure sores related to the nutritional state. Clin Nutr. 1991;10:245–50.

    Article  CAS  PubMed  Google Scholar 

  67. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in orthopaedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e278S–325S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Handoll HH, Farrar MJ, McBirnie J, Tytherleigh-Strong G, Milne AA, Gillespie WJ. Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures. Cochrane Database Syst Rev. 2002;2:CD000305.

    Google Scholar 

  69. Cohen AT, Skinner JA, Warwick D, Brenkel I. The use of graduated compression stockings in association with fondaparinux in surgery of the hip. A multicentre, multinational, randomised, open-label, parallel-group comparative study. J Bone Joint Surg Br. 2007;89:887–92.

    Article  CAS  PubMed  Google Scholar 

  70. Marsland D, Mears SM, Kates SL. Venous thromboembolic prophylaxis for hip fractures. Osteoporos Int. 2010;21(Suppl 4):S593–604.

    Article  CAS  PubMed  Google Scholar 

  71. Thaler HW, Roller RE, Greiner N, Sim E, Korninger C. Thromboprophylaxis with 60 mg enoxaparin is safe in hip trauma surgery. J Trauma. 2001;51:518–21.

    CAS  PubMed  Google Scholar 

  72. Eriksson BI, Bauer KA, Lassen MR, Turpie AG. Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med. 2001;345:1298–304.

    Article  CAS  PubMed  Google Scholar 

  73. Eriksson BI, Lassen MR, Colwell CW Jr. Efficacy of fondaparinux for thromboprophylaxis in hip fracture patients. J Arthroplast. 2004;19:78–81.

    Article  Google Scholar 

  74. Long A, Zhang L, Zhang Y, Jiang B, Mao Z, Li H, et al. Efficacy and safety of rivaroxaban versus low-molecular-weight heparin therapy in patients with lower limb fractures. J Thromb Thrombolysis. 2014;38:299–305.

    Article  CAS  PubMed  Google Scholar 

  75. Powers PJ, Gent M, Jay RM, Julian DH, Turpie AG, Levine M, et al. A randomized trial of less intense postoperative warfarin or aspirin therapy in the prevention of venous thromboembolism after surgery for fractured hip. Arch Intern Med. 1989;149(4):771.

    Article  CAS  PubMed  Google Scholar 

  76. Ji HM, Lee YK, Ha YC, Kim KC, Koo KH. Little impact of antiplatelet agents on venous thromboembolism after hip fracture surgery. J Korean Med Sci. 2011;26:1625–9.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Stewart DW, Freshour JE. Aspirin for the prophylaxis of venous thromboembolic events in orthopaedic surgery patients: a comparison of the AAOS and ACCP guidelines with review of the evidence. Ann Pharmacother. 2013;47:63–74.

    Article  PubMed  CAS  Google Scholar 

  78. Huang Z, Himes JH, McGovern PG. Nutrition and subsequent hip fracture risk among a national cohort of white women. Am J Epidemiol. 1996;144:124–34.

    Article  CAS  PubMed  Google Scholar 

  79. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr. 1999;69:147–52.

    CAS  PubMed  Google Scholar 

  80. Avenell A, Handoll HH. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev. 2010;11:CD001880.

    Google Scholar 

  81. Bell JJ, Bauer JD, Capra S, Pulle RC. Quick and easy is not without cost: implications of poorly performing nutrition screening tools in hip fracture. J Am Geriatr Soc. 2014;62:237–43.

    Article  PubMed  Google Scholar 

  82. Miller RR, Ballew SH, Shardell MD, Hicks GE, Hawkes WG, Resnick B, et al. Repeat falls and the recovery of social participation in the year post-hip fracture. Age Ageing. 2009;38(5):570.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD. Ambulatory ability after hip fracture. A prospective study in geriatric patients. Clin Orthop Relat Res. 1995;310:150–9.

    Google Scholar 

  84. Sherrington C, Tiedemann A, Cameron I. Physical exercise after hip fracture: an evidence overview. Eur J Phys Rehabil Med. 2011;47:297–307.

    CAS  PubMed  Google Scholar 

  85. Siu AL, Penrod JD, Boockvar KS, Koval K, Strauss E, Morrison RS. Early ambulation after hip fracture: effects on function and mortality. Arch Intern Med. 2006;166:766–71.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Cree M, Hayduk L, Soskolne CL, Suarez-Almazor M. Modeling changes in health perception following hip fracture. Qual Life Res. 2001;10:651–9.

    Article  CAS  PubMed  Google Scholar 

  87. Heruti RJ, Lusky A, Barell V, Ohry A, Adunsky A. Cognitive status at admission: does it affect the rehabilitation outcome of elderly patients with hip fracture? Arch Phys Med Rehabil. 1999;80:432–6.

    Article  CAS  PubMed  Google Scholar 

  88. Lenze EJ, Skidmore ER, Dew MA, Butters MA, Rogers JC, Begley A, et al. Does depression, apathy or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? Gen Hosp Psychiatry. 2007;29:141–6.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Petrella RJ, Payne M, Myers A, Overend T, Chesworth B. Physical function and fear of falling after hip fracture rehabilitation in the elderly. Am J Phys Med Rehabil. 2000;79:154–60.

    Article  CAS  PubMed  Google Scholar 

  90. Binder EF, Brown M, Sinacore DR, Steger-May K, Yarasheski KE, Schechtman KB. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA. 2004;292:837–46.

    Article  CAS  PubMed  Google Scholar 

  91. Ceder L, Ekelund L, Inerot S, Lindberg L, Odberg E, Sjolin C. Rehabilitation after hip fracture in the elderly. Acta Orthop Scand. 1979;50:681–8.

    Article  CAS  PubMed  Google Scholar 

  92. Huusko TM, Karppi P, Avikainen V, Kautiainen H, Sulkava R. Intensive geriatric rehabilitation of hip fracture patients: a randomized, controlled trial. Acta Orthop Scand. 2002;73:425–31.

    Article  PubMed  Google Scholar 

  93. Tinetti ME, Baker DI, Gottschalk M, Williams CS, Pollack D, Garrett P, et al. Home-based multicomponent rehabilitation program for older persons after hip fracture: a randomized trial. Arch Phys Med Rehabil. 1999;80:916–22.

    Article  CAS  PubMed  Google Scholar 

  94. Dyer CB, Ashton CM, Teasdale TA. Postoperative delirium. A review of 80 primary data-collection studies. Arch Intern Med. 1995;155:461–5.

    Article  CAS  PubMed  Google Scholar 

  95. Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA, Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009;249:173–8.

    Article  PubMed  Google Scholar 

  96. Litaker D, Locala J, Franco K, Bronson DL, Tannous Z. Preoperative risk factors for postoperative delirium. Gen Hosp Psychiatry. 2001;23:84–9.

    Article  CAS  PubMed  Google Scholar 

  97. Bitsch M, Foss N, Kristensen B, Kehlet H. Pathogenesis of and management strategies for postoperative delirium after hip fracture: a review. Acta Orthop Scand. 2004;75:378–89.

    Article  PubMed  Google Scholar 

  98. Ilango S, Pulle RC, Bell J, Kuys SS. General versus spinal anaesthesia and postoperative delirium in an orthogeriatric population. Australas J Ageing. 2015;35(1):42–7.

    Article  PubMed  Google Scholar 

  99. NICE. Hip fracture. In: National Institute of Health and Care Excellence, editor. The management of hip fracture in adults. Update, March 2014 ed. London: NICE; 2011. p. 32.

    Google Scholar 

  100. Marcantonio ER, Juarez G, Goldman L, Mangione CM, Ludwig LE, Lind L, et al. The relationship of postoperative delirium with psychoactive medications. JAMA. 1994;272:1518–22.

    Article  CAS  PubMed  Google Scholar 

  101. Zywiel MG, Hurley RT, Perruccio AV, Hancock-Howard RL, Coyte PC, Rampersaud YR. Health economic implications of perioperative delirium in older patients after surgery for a fragility hip fracture. J Bone Joint Surg Am. 2015;97:829–36.

    Article  PubMed  Google Scholar 

  102. Abraha I, Trotta F, Rimland JM, Cruz-Jentoft A, Lozano-Montoya I, Soiza RL, et al. Efficacy of non-pharmacological interventions to prevent and treat delirium in older patients: a systematic overview. The SENATOR project ONTOP series. PLoS One. 2015;10:e0123090.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  103. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc. 2015;63:142–50.

    Article  Google Scholar 

  104. Della Rocca GJ, Moylan KC, Crist BD, Volgas DA, Stannard JP, Mehr DR. Comanagement of geriatric patients with hip fractures: a retrospective, controlled, cohort study. Geriatr Orthop Surg Rehabil. 2013;4:10–5.

    Article  PubMed  Google Scholar 

  105. Lefaivre KA, Macadam SA, Davidson DJ, Gandhi R, Chan H, Broekhuyse HM. Length of stay, mortality, morbidity and delay to surgery in hip fractures. J Bone Joint Surg Br. 2009;91(7):922.

    Article  CAS  PubMed  Google Scholar 

  106. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45:M101–7.

    Article  CAS  PubMed  Google Scholar 

  107. Services CfMaM. The inpatient rehabilitation facility – patient assessment instrument (IRF-PAI) training manual. Washington, DC; 2012.

    Google Scholar 

  108. Nakamura K, Takahashi S, Oyama M, Oshiki R, Kobayashi R, Saito T, et al. Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people. Osteoporos Int. 2010;21:1411–6.

    Article  CAS  PubMed  Google Scholar 

  109. Balasubramanian A, Tosi LL, Lane JM, Dirschl DR, Ho PR, O’Malley CD. Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009. J Bone Joint Surg Am. 2014;96:e52.

    Article  PubMed  Google Scholar 

  110. Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25:2359–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Bischoff-Ferrari HA, Dawson-Hughes B, Whiting SJ. Vitamin D supplementation and fracture risk. Arch Intern Med. 2011;171:265. author reply-6

    Article  PubMed  Google Scholar 

  112. Dell R. Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int. 2011;22(Suppl 3):457–60.

    Article  PubMed  Google Scholar 

  113. Tosi LL, Gliklich R, Kannan K, Koval KJ. The American Orthopaedic Association’s “own the bone” initiative to prevent secondary fractures. J Bone Joint Surg Am. 2008;90:163–73.

    Article  PubMed  Google Scholar 

  114. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.

    Article  CAS  PubMed  Google Scholar 

  115. Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O'Brien LA, et al. Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med. 1991;324:1326–31.

    Article  CAS  PubMed  Google Scholar 

  116. Tinetti ME, Kumar C. The patient who falls: “it’s always a trade-off”. JAMA. 2010;303:258–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  117. Nevitt MC, Cummings SR, Hudes ES. Risk factors for injurious falls: a prospective study. J Gerontol. 1991;46:M164–70.

    Article  CAS  PubMed  Google Scholar 

  118. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21:658–68.

    Article  PubMed  Google Scholar 

  119. AGS. AGS/BGS clinical practice guideline: prevention of falls in older persons. American Geriatrics Society; 2015.

    Google Scholar 

  120. Gillespie L, Handoll H. Prevention of falls and fall-related injuries in older people. Inj Prev. 2009;15(5):354.

    Article  CAS  PubMed  Google Scholar 

  121. Cameron ID, Murray GR, Gillespie LD, Robertson MC, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010;1:CD005465.

    Google Scholar 

  122. Zerr KJ, Furnary AP, Grunkemeier GL, Bookin S, Kanhere V, Starr A. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–61.

    Article  CAS  PubMed  Google Scholar 

  123. APIC. Guide to the elimination of orthopaedic surgical site infections. Washington, DC: APIC; 2010. p. 79.

    Google Scholar 

  124. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20:250–78. quiz 79–80

    Article  CAS  PubMed  Google Scholar 

  125. Aggarwal VK, Tischler EH, Lautenbach C, Williams GR Jr, Abboud JA, Altena M, et al. Mitigation and education. J Orthop Res. 2014;32(Suppl 1):S16–25.

    PubMed  Google Scholar 

  126. Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res. 2002;103:89–95.

    Article  PubMed  Google Scholar 

  127. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36:592–8.

    Article  PubMed  Google Scholar 

  128. Bode LG, Kluytmans JA, Wertheim HF, Bogaers D, Vandenbroucke-Grauls CM, Roosendaal R, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362:9–17.

    Article  CAS  PubMed  Google Scholar 

  129. Perl TM, Cullen JJ, Wenzel RP, Zimmerman MB, Pfaller MA, Sheppard D, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med. 2002;346:1871–7.

    Article  CAS  PubMed  Google Scholar 

  130. Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS. Adverse effects of preoperative steroid use on surgical outcomes. Am J Surg. 2011;201:305–8. discussion 8–9

    Article  CAS  PubMed  Google Scholar 

  131. Yano K, Minoda Y, Sakawa A, Kuwano Y, Kondo K, Fukushima W, et al. Positive nasal culture of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infection in orthopaedics. Acta Orthop. 2009;80:486–90.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Wilcox MH, Hall J, Pike H, Templeton PA, Fawley WN, Parnell P, et al. Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections. J Hosp Infect. 2003;54:196–201.

    Article  CAS  PubMed  Google Scholar 

  133. Rao N, Cannella B, Crossett LS, Yates AJ Jr, McGough R. A preoperative decolonization protocol for staphylococcus aureus prevents orthopaedic infections. Clin Orthop Relat Res. 2008;466:1343–8.

    Article  PubMed  PubMed Central  Google Scholar 

  134. Kawakami K, Ikari K, Kawamura K, Tsukahara S, Iwamoto T, Yano K, et al. Complications and features after joint surgery in rheumatoid arthritis patients treated with tumour necrosis factor-alpha blockers: perioperative interruption of tumour necrosis factor-alpha blockers decreases complications? Rheumatology. 2010;49:341–7.

    Article  CAS  PubMed  Google Scholar 

  135. Prokuski L, Clyburn TA, Evans RP, Moucha CS. Prophylactic antibiotics in orthopaedic surgery. Instr Course Lect. 2011;60:545–55.

    PubMed  Google Scholar 

  136. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992;326:281–6.

    Article  CAS  PubMed  Google Scholar 

  137. Pavel A, Smith RL, Ballard A, Larson IJ. Prophylactic antibiotics in elective orthopaedic surgery: a prospective study of 1,591 cases. South Med J. 1977;70(Suppl 1):50–5.

    Article  PubMed  Google Scholar 

  138. Burnett JW, Gustilo RB, Williams DN, Kind AC. Prophylactic antibiotics in hip fractures. A double-blind, prospective study. J Bone Joint Surg Am. 1980;62:457–62.

    Article  CAS  PubMed  Google Scholar 

  139. Nelson CL, Nicholas RW. Prophylactic antibiotics in clean surgery. Instr Course Lect. 2002;51:553–7.

    PubMed  Google Scholar 

  140. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27:97–132. quiz 3–4; discussion 96

    Article  CAS  PubMed  Google Scholar 

  141. Maki DG, Ringer M, Alvarado CJ. Prospective randomised trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet. 1991;338:339–43.

    Article  CAS  PubMed  Google Scholar 

  142. Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013;95-B:1450–2.

    Article  CAS  PubMed  Google Scholar 

  143. Zinn J, Jenkins JB, Swofford V, Harrelson B, McCarter S. Intraoperative patient skin prep agents: is there a difference? AORN J. 2010;92:662–74.

    Article  PubMed  Google Scholar 

  144. Lee I, Agarwal RK, Lee BY, Fishman NO, Umscheid CA. Systematic review and cost analysis comparing use of chlorhexidine with use of iodine for preoperative skin antisepsis to prevent surgical site infection. Infect Control Hosp Epidemiol. 2010;31:1219–29.

    Article  CAS  PubMed  Google Scholar 

  145. Ostrander RV, Botte MJ, Brage ME. Efficacy of surgical preparation solutions in foot and ankle surgery. J Bone Joint Surg Am. 2005;87(5):980.

    Article  PubMed  Google Scholar 

  146. Tanner J, Swarbrook S, Stuart J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev. 2008;1:CD004288.

    Google Scholar 

  147. Leong G, Wilson J, Charlett A. Duration of operation as a risk factor for surgical site infection: comparison of English and US data. J Hosp Infect. 2006;63:255–62.

    Article  CAS  PubMed  Google Scholar 

  148. Molinari RW, Khera OA, Molinari WJ. Prophylactic intraoperative powdered vancomycin and postoperative deep spinal wound infection: 1,512 consecutive surgical cases over a 6-year period. Eur. Spine J. 2012;21(Suppl 4):S476–82.

    Article  Google Scholar 

  149. Andersson AE, Bergh I, Karlsson J, Eriksson BI, Nilsson K. Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopaedic trauma implant surgery. Am J Infect Control. 2012;40:750–5.

    Article  PubMed  Google Scholar 

  150. Panahi P, Stroh M, Casper DS, Parvizi J, Austin MS. Operating room traffic is a major concern during total joint arthroplasty. Clin Orthop Relat Res. 2012;470:2690–4.

    Article  PubMed  PubMed Central  Google Scholar 

  151. Lynch RJ, Englesbe MJ, Sturm L, Bitar A, Budhiraj K, Kolla S, et al. Measurement of foot traffic in the operating room: implications for infection control. Am J Med Qual. 2009;24:45–52.

    Article  PubMed  Google Scholar 

  152. Rutala WA, Weber DJ. Disinfection and sterilization: an overview. Am J Infect Control. 2013;41:S2–5.

    Article  PubMed  Google Scholar 

  153. Campbell DA Jr, Henderson WG, Englesbe MJ, Hall BL, O’Reilly M, Bratzler D, et al. Surgical site infection prevention: the importance of operative duration and blood transfusion–results of the first American College of Surgeons-National Surgical Quality Improvement Program Best Practices Initiative. J Am Coll Surg. 2008;207:810–20.

    Article  PubMed  Google Scholar 

  154. Bernard AC, Davenport DL, Chang PK, Vaughan TB, Zwischenberger JB. Intraoperative transfusion of 1 U to 2 U packed red blood cells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients. J Am Coll Surg. 2009;208:931–7. 7e1–2; discussion 8–9

    Article  PubMed  Google Scholar 

  155. Bryant DM, Sanders DW, Coles CP, Petrisor BA, Jeray KJ, Laflamme GY. Selection of outcome measures for patients with hip fracture. J Orthop Trauma. 2009;23:434–41.

    Article  PubMed  Google Scholar 

  156. Latham NK, Mehta V, Nguyen AM, Jette AM, Olarsch S, Papanicolaou D, et al. Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients? Arch Phys Med Rehabil. 2008;89:2146–55.

    Article  PubMed  Google Scholar 

  157. Liem IS, Kammerlander C, Suhm N, Kates SL, Blauth M. Literature review of outcome parameters used in studies of geriatric fracture centers. Arch Orthop Trauma Surg. 2014;134:181–7.

    Article  CAS  PubMed  Google Scholar 

  158. Liem IS, Kammerlander C, Suhm N, Blauth M, Roth T, Gosch M, et al. Identifying a standard set of outcome parameters for the evaluation of orthogeriatric co-management for hip fractures. Injury. 2013;44:1403–12.

    Article  CAS  PubMed  Google Scholar 

  159. Joint Commission. Types of disease-specific care programs certified; 2015.

    Google Scholar 

  160. Mears SC, Suk M, Cobbe F, Kates SL. International Geriatric Fracture Society CORE certification: turning knowledge into action. Geriatr Orthop Surg Rehabil. 2014;5:91–2.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA

    Nathan Kaplan

  2. Department of Orthopaedic Surgery, Virginia Commonwealth University, West Hospital, 1200 East Broad Street, 9th Floor, West Wing, Richmond, VA, 23298-0153, USA

    Stephen L. Kates

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Correspondence to Stephen L. Kates .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, New York University School of Medicine, New York, New York, USA

    Kenneth A. Egol

  2. Department of Orthopedic Surgery, New York University School of Medicine, New York, New York, USA

    Philipp Leucht

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Kaplan, N., Kates, S.L. (2018). Quality and Safety. In: Egol, K., Leucht, P. (eds) Proximal Femur Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-64904-7_13

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