Pelvic fragility fractures in older people admitted to hospital: the clinical burden
Pelvic fragility fractures are common in older people. To deliver better care in hospital, a better understanding of their characteristics and outcomes post-hospitalisation will allow clinicians to better design hospital services to manage their needs.
Using routinely collected electronic hospital records over 3 months, data were collected and analysed on consecutive patients admitted with pelvic fragility fractures (as defined by a pelvic fracture sustaining following a fall from standing height or less) to acute medical wards for older people.
Twenty-four patients were admitted over this period. Their mean age was 87 years (SD 9.4), the majority were female (83%), a significant proportion had cognitive impairment with an abbreviated mental test score of ≤ 7 (67%), and the median number of comorbid conditions was three. These patients were at high risk of future fractures (50% with a known diagnosis of osteoporosis; significant FRAX scores; 75% had a fall) but only 50% had a bone health assessment. The median duration in hospital was 13 days. 33% of patients were discharged home directly while the rest were discharged to either a care home or another hospital for further rehabilitation. 54% had a hospital-related complication including kidney injury, delirium, and hospital-acquired infections—there were two inpatient mortalities. At 3 months post-fracture, 54% were readmitted and 33% died.
Pelvic fragility fractures are associated with worse inpatient and post-discharge clinical outcomes. This is an older multi-morbid cohort needing significant post-fracture rehabilitation care. Their care in hospital needs to address their management complexities.
KeywordsAged Pelvic fracture Hospital
The author group is grateful for the support provided by the Department of Healthcare for Older People. T.O. is a recipient of a research training fellowship from the Dunhill Medical Trust (Grant No. RTF49/0114). No funds were obtained for this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest associated with this study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Data were extracted from routinely collected service data in compliance with the hospital’s procedure and information governance standards. Informed consent was not required as part of a hospital improvement project.
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