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A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair: secondary analysis of the FOCUS trial
Abstract Objective To determine if adjusted mortality, walking ability or return home differed after hip fracture surgery between Canada and the USA. Design Secondary analysis of the Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS) trial data. Setting Da...
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| Published in: | International journal for quality in health care 2018-03, Vol.30 (2), p.97-103 |
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| container_title | International journal for quality in health care |
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| creator | BEAUPRE, LAUREN A. WAI, EUGENE K. HOOVER, DONALD R. NOVECK, HELAINE ROFFEY, DARREN M. COOK, DONALD R. MAGAZINER, JAY S. CARSON, JEFFREY L. |
| description | Abstract
Objective
To determine if adjusted mortality, walking ability or return home differed after hip fracture surgery between Canada and the USA.
Design
Secondary analysis of the Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS) trial data.
Setting
Data were collected from 47 American and Canadian hospitals.
Participants
Overall, 2016 subjects with a hip fracture (USA = 1222 (60.6%); Canada = 794 (39.4%)) were randomized to a liberal or restrictive transfusion strategy. Subjects were 50 years and older, with cardiovascular disease and/or risk factors and hemoglobin |
| doi_str_mv | 10.1093/intqhc/mzx199 |
| format | article |
| fullrecord | <record><control><sourceid>jstor_TOX</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5890863</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48519814</jstor_id><oup_id>10.1093/intqhc/mzx199</oup_id><sourcerecordid>48519814</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-cd5bc5145da8b03a48787c4d0359bbecd38134b25caa8c4ffa04ee41aaedc5eb3</originalsourceid><addsrcrecordid>eNqFkc1P3DAQxa2KqlDg2CPIx15S7LWdOBcktOqXhNRDy9maOBPWaGMH2-Hrr8codNueeprRzE9vnuYR8oGzT5y14sz5fLuxZ-PTA2_bN-SAy1pWom6avdILJSqpmNon71O6YYzXQtXvyP6qFVpJWR-Q8YLaME4QXQqehoGGOZcBJtphvkf0dA0eeqDge5o3SK-8y9jTnxlygZynE2SHPica0YY7jM5f0yGGkW7cVBqweY5YlhO4eETeDrBNePxaD8nVl8-_1t-qyx9fv68vLisr5SpXtledVVyqHnTHBEjd6MbKngnVdh3aXmguZLdSFkBbOQzAJKLkANhbhZ04JOeL7jR3Y5kVfxG2ZopuhPhoAjjz78a7jbkOd0bplulaFIGPrwIx3M6YshldsrjdgscwJ1N-LYSum9ULWi2ojSGliMPuDGfmJSKzRGSWiAp_-re3Hf07kz-3wzz9V-tkQW9SDnEHS614q7kUz77kqvo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1993386723</pqid></control><display><type>article</type><title>A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair: secondary analysis of the FOCUS trial</title><source>Oxford Open</source><creator>BEAUPRE, LAUREN A. ; WAI, EUGENE K. ; HOOVER, DONALD R. ; NOVECK, HELAINE ; ROFFEY, DARREN M. ; COOK, DONALD R. ; MAGAZINER, JAY S. ; CARSON, JEFFREY L.</creator><creatorcontrib>BEAUPRE, LAUREN A. ; WAI, EUGENE K. ; HOOVER, DONALD R. ; NOVECK, HELAINE ; ROFFEY, DARREN M. ; COOK, DONALD R. ; MAGAZINER, JAY S. ; CARSON, JEFFREY L.</creatorcontrib><description>Abstract
Objective
To determine if adjusted mortality, walking ability or return home differed after hip fracture surgery between Canada and the USA.
Design
Secondary analysis of the Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS) trial data.
Setting
Data were collected from 47 American and Canadian hospitals.
Participants
Overall, 2016 subjects with a hip fracture (USA = 1222 (60.6%); Canada = 794 (39.4%)) were randomized to a liberal or restrictive transfusion strategy. Subjects were 50 years and older, with cardiovascular disease and/or risk factors and hemoglobin <100 g/L within 3 days post-surgery. The average age was 82 years and 1527(76%) subjects were females.
Intervention
Demographics, health status and health services data were collected up to 60 days post-surgery and mortality to a median of 3 years post-surgery.
Main outcomes
Mortality, inability to walk and return home.
Results
US subjects had higher adjusted mortality than Canadians at 30 days (odds ratio = 1.78; 95% confidence interval: 1.09–2.90), 60 days (1.53; 1.02–2.29) and up to 3 years (hazard ratio = 1.25; 1.07–1.45). There were no differences in adjusted outcomes for walking ability or return home at 30 or 60 days post-surgery. Median hospital length of stay was longer (P < 0.0001) in Canada (9 days; interquartile range: 5–18 days) than the US (3 days; 2–5 days). US subjects (52.9%) were more likely than Canadians (16.8%) to be discharged to nursing homes for rehabilitation (P < 0.001).
Conclusions
Adjusted survival favored Canadians post hip fracture while walking ability and return home were not different between countries. The reason(s) for mortality differences warrant further investigation.</description><identifier>ISSN: 1353-4505</identifier><identifier>EISSN: 1464-3677</identifier><identifier>DOI: 10.1093/intqhc/mzx199</identifier><identifier>PMID: 29385446</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Blood Transfusion - statistics & numerical data ; Canada - epidemiology ; Female ; Hip Fractures - mortality ; Hip Fractures - rehabilitation ; Hip Fractures - surgery ; Humans ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Nursing Homes - statistics & numerical data ; Postoperative Care ; Recovery of Function ; Risk Factors ; United States - epidemiology ; Walking</subject><ispartof>International journal for quality in health care, 2018-03, Vol.30 (2), p.97-103</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-cd5bc5145da8b03a48787c4d0359bbecd38134b25caa8c4ffa04ee41aaedc5eb3</citedby><cites>FETCH-LOGICAL-c442t-cd5bc5145da8b03a48787c4d0359bbecd38134b25caa8c4ffa04ee41aaedc5eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48519814$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48519814$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,780,784,885,1603,27923,27924,58237,58470</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/intqhc/mzx199$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29385446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BEAUPRE, LAUREN A.</creatorcontrib><creatorcontrib>WAI, EUGENE K.</creatorcontrib><creatorcontrib>HOOVER, DONALD R.</creatorcontrib><creatorcontrib>NOVECK, HELAINE</creatorcontrib><creatorcontrib>ROFFEY, DARREN M.</creatorcontrib><creatorcontrib>COOK, DONALD R.</creatorcontrib><creatorcontrib>MAGAZINER, JAY S.</creatorcontrib><creatorcontrib>CARSON, JEFFREY L.</creatorcontrib><title>A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair: secondary analysis of the FOCUS trial</title><title>International journal for quality in health care</title><addtitle>Int J Qual Health Care</addtitle><description>Abstract
Objective
To determine if adjusted mortality, walking ability or return home differed after hip fracture surgery between Canada and the USA.
Design
Secondary analysis of the Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS) trial data.
Setting
Data were collected from 47 American and Canadian hospitals.
Participants
Overall, 2016 subjects with a hip fracture (USA = 1222 (60.6%); Canada = 794 (39.4%)) were randomized to a liberal or restrictive transfusion strategy. Subjects were 50 years and older, with cardiovascular disease and/or risk factors and hemoglobin <100 g/L within 3 days post-surgery. The average age was 82 years and 1527(76%) subjects were females.
Intervention
Demographics, health status and health services data were collected up to 60 days post-surgery and mortality to a median of 3 years post-surgery.
Main outcomes
Mortality, inability to walk and return home.
Results
US subjects had higher adjusted mortality than Canadians at 30 days (odds ratio = 1.78; 95% confidence interval: 1.09–2.90), 60 days (1.53; 1.02–2.29) and up to 3 years (hazard ratio = 1.25; 1.07–1.45). There were no differences in adjusted outcomes for walking ability or return home at 30 or 60 days post-surgery. Median hospital length of stay was longer (P < 0.0001) in Canada (9 days; interquartile range: 5–18 days) than the US (3 days; 2–5 days). US subjects (52.9%) were more likely than Canadians (16.8%) to be discharged to nursing homes for rehabilitation (P < 0.001).
Conclusions
Adjusted survival favored Canadians post hip fracture while walking ability and return home were not different between countries. The reason(s) for mortality differences warrant further investigation.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Canada - epidemiology</subject><subject>Female</subject><subject>Hip Fractures - mortality</subject><subject>Hip Fractures - rehabilitation</subject><subject>Hip Fractures - surgery</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nursing Homes - statistics & numerical data</subject><subject>Postoperative Care</subject><subject>Recovery of Function</subject><subject>Risk Factors</subject><subject>United States - epidemiology</subject><subject>Walking</subject><issn>1353-4505</issn><issn>1464-3677</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkc1P3DAQxa2KqlDg2CPIx15S7LWdOBcktOqXhNRDy9maOBPWaGMH2-Hrr8codNueeprRzE9vnuYR8oGzT5y14sz5fLuxZ-PTA2_bN-SAy1pWom6avdILJSqpmNon71O6YYzXQtXvyP6qFVpJWR-Q8YLaME4QXQqehoGGOZcBJtphvkf0dA0eeqDge5o3SK-8y9jTnxlygZynE2SHPica0YY7jM5f0yGGkW7cVBqweY5YlhO4eETeDrBNePxaD8nVl8-_1t-qyx9fv68vLisr5SpXtledVVyqHnTHBEjd6MbKngnVdh3aXmguZLdSFkBbOQzAJKLkANhbhZ04JOeL7jR3Y5kVfxG2ZopuhPhoAjjz78a7jbkOd0bplulaFIGPrwIx3M6YshldsrjdgscwJ1N-LYSum9ULWi2ojSGliMPuDGfmJSKzRGSWiAp_-re3Hf07kz-3wzz9V-tkQW9SDnEHS614q7kUz77kqvo</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>BEAUPRE, LAUREN A.</creator><creator>WAI, EUGENE K.</creator><creator>HOOVER, DONALD R.</creator><creator>NOVECK, HELAINE</creator><creator>ROFFEY, DARREN M.</creator><creator>COOK, DONALD R.</creator><creator>MAGAZINER, JAY S.</creator><creator>CARSON, JEFFREY L.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180301</creationdate><title>A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair</title><author>BEAUPRE, LAUREN A. ; WAI, EUGENE K. ; HOOVER, DONALD R. ; NOVECK, HELAINE ; ROFFEY, DARREN M. ; COOK, DONALD R. ; MAGAZINER, JAY S. ; CARSON, JEFFREY L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-cd5bc5145da8b03a48787c4d0359bbecd38134b25caa8c4ffa04ee41aaedc5eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Transfusion - statistics & numerical data</topic><topic>Canada - epidemiology</topic><topic>Female</topic><topic>Hip Fractures - mortality</topic><topic>Hip Fractures - rehabilitation</topic><topic>Hip Fractures - surgery</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nursing Homes - statistics & numerical data</topic><topic>Postoperative Care</topic><topic>Recovery of Function</topic><topic>Risk Factors</topic><topic>United States - epidemiology</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BEAUPRE, LAUREN A.</creatorcontrib><creatorcontrib>WAI, EUGENE K.</creatorcontrib><creatorcontrib>HOOVER, DONALD R.</creatorcontrib><creatorcontrib>NOVECK, HELAINE</creatorcontrib><creatorcontrib>ROFFEY, DARREN M.</creatorcontrib><creatorcontrib>COOK, DONALD R.</creatorcontrib><creatorcontrib>MAGAZINER, JAY S.</creatorcontrib><creatorcontrib>CARSON, JEFFREY L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal for quality in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>BEAUPRE, LAUREN A.</au><au>WAI, EUGENE K.</au><au>HOOVER, DONALD R.</au><au>NOVECK, HELAINE</au><au>ROFFEY, DARREN M.</au><au>COOK, DONALD R.</au><au>MAGAZINER, JAY S.</au><au>CARSON, JEFFREY L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair: secondary analysis of the FOCUS trial</atitle><jtitle>International journal for quality in health care</jtitle><addtitle>Int J Qual Health Care</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>30</volume><issue>2</issue><spage>97</spage><epage>103</epage><pages>97-103</pages><issn>1353-4505</issn><eissn>1464-3677</eissn><abstract>Abstract
Objective
To determine if adjusted mortality, walking ability or return home differed after hip fracture surgery between Canada and the USA.
Design
Secondary analysis of the Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS) trial data.
Setting
Data were collected from 47 American and Canadian hospitals.
Participants
Overall, 2016 subjects with a hip fracture (USA = 1222 (60.6%); Canada = 794 (39.4%)) were randomized to a liberal or restrictive transfusion strategy. Subjects were 50 years and older, with cardiovascular disease and/or risk factors and hemoglobin <100 g/L within 3 days post-surgery. The average age was 82 years and 1527(76%) subjects were females.
Intervention
Demographics, health status and health services data were collected up to 60 days post-surgery and mortality to a median of 3 years post-surgery.
Main outcomes
Mortality, inability to walk and return home.
Results
US subjects had higher adjusted mortality than Canadians at 30 days (odds ratio = 1.78; 95% confidence interval: 1.09–2.90), 60 days (1.53; 1.02–2.29) and up to 3 years (hazard ratio = 1.25; 1.07–1.45). There were no differences in adjusted outcomes for walking ability or return home at 30 or 60 days post-surgery. Median hospital length of stay was longer (P < 0.0001) in Canada (9 days; interquartile range: 5–18 days) than the US (3 days; 2–5 days). US subjects (52.9%) were more likely than Canadians (16.8%) to be discharged to nursing homes for rehabilitation (P < 0.001).
Conclusions
Adjusted survival favored Canadians post hip fracture while walking ability and return home were not different between countries. The reason(s) for mortality differences warrant further investigation.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29385446</pmid><doi>10.1093/intqhc/mzx199</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford Open |
| subjects | Aged Aged, 80 and over Blood Transfusion - statistics & numerical data Canada - epidemiology Female Hip Fractures - mortality Hip Fractures - rehabilitation Hip Fractures - surgery Humans Length of Stay - statistics & numerical data Male Middle Aged Nursing Homes - statistics & numerical data Postoperative Care Recovery of Function Risk Factors United States - epidemiology Walking |
| title | A comparison of outcomes between Canada and the United States in patients recovering from hip fracture repair: secondary analysis of the FOCUS trial |
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