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An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery

‘Days alive and at home’ is a validated measure that estimates the time spent at home, defined as the place of residence before admission to hospital. We evaluated this metric in older adults after hip fracture surgery and assessed two follow‐up durations, 30 and 90 days. Patients aged ≥ 70 years wh...

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Autores principales: Wu, A., Fahey, M. T., Cui, D., El‐Behesy, B., Story, D. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543156/
https://www.ncbi.nlm.nih.gov/pubmed/35489814
http://dx.doi.org/10.1111/anae.15742
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author Wu, A.
Fahey, M. T.
Cui, D.
El‐Behesy, B.
Story, D. A.
author_facet Wu, A.
Fahey, M. T.
Cui, D.
El‐Behesy, B.
Story, D. A.
author_sort Wu, A.
collection PubMed
description ‘Days alive and at home’ is a validated measure that estimates the time spent at home, defined as the place of residence before admission to hospital. We evaluated this metric in older adults after hip fracture surgery and assessed two follow‐up durations, 30 and 90 days. Patients aged ≥ 70 years who underwent hip fracture surgery were identified retrospectively via hospital admission and government mortality records. Patients who successfully returned home and were still alive within 90 days of surgery were distinguished from those who were not. Regression models were used to examine which variables were associated with failure to return home and number of days at home among those who did return, within 90 days of surgery. We analysed the records of 825 patients. Median (IQR [range]) number of days at home within 90 days (n = 788) was 54 (0–76 [0–88]) days and within 30 days (n = 797) it was 2 (0–21 [0–28]) days. Out of these, 274 (35%) patients did not return home within 90 days and 374 (47%) within 30 days after surgery. Known peri‐operative risk‐factors such as older age, pre‐operative anaemia and postoperative acute renal impairment were associated with failure to return home. This study supports days alive and at home as a useful patient‐centred outcome measure in older adults after hip fracture surgery. We recommend that this metric should be used in clinical trials and measured at 90, rather than 30, postoperative days. As nearly half of this patient population did not return home within 30 days, the shorter time‐period catches fewer meaningful events.
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spelling pubmed-95431562022-10-14 An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery Wu, A. Fahey, M. T. Cui, D. El‐Behesy, B. Story, D. A. Anaesthesia Original Articles ‘Days alive and at home’ is a validated measure that estimates the time spent at home, defined as the place of residence before admission to hospital. We evaluated this metric in older adults after hip fracture surgery and assessed two follow‐up durations, 30 and 90 days. Patients aged ≥ 70 years who underwent hip fracture surgery were identified retrospectively via hospital admission and government mortality records. Patients who successfully returned home and were still alive within 90 days of surgery were distinguished from those who were not. Regression models were used to examine which variables were associated with failure to return home and number of days at home among those who did return, within 90 days of surgery. We analysed the records of 825 patients. Median (IQR [range]) number of days at home within 90 days (n = 788) was 54 (0–76 [0–88]) days and within 30 days (n = 797) it was 2 (0–21 [0–28]) days. Out of these, 274 (35%) patients did not return home within 90 days and 374 (47%) within 30 days after surgery. Known peri‐operative risk‐factors such as older age, pre‐operative anaemia and postoperative acute renal impairment were associated with failure to return home. This study supports days alive and at home as a useful patient‐centred outcome measure in older adults after hip fracture surgery. We recommend that this metric should be used in clinical trials and measured at 90, rather than 30, postoperative days. As nearly half of this patient population did not return home within 30 days, the shorter time‐period catches fewer meaningful events. John Wiley and Sons Inc. 2022-04-30 2022-08 /pmc/articles/PMC9543156/ /pubmed/35489814 http://dx.doi.org/10.1111/anae.15742 Text en © 2022 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Wu, A.
Fahey, M. T.
Cui, D.
El‐Behesy, B.
Story, D. A.
An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title_full An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title_fullStr An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title_full_unstemmed An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title_short An evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
title_sort evaluation of the outcome metric ‘days alive and at home’ in older patients after hip fracture surgery
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9543156/
https://www.ncbi.nlm.nih.gov/pubmed/35489814
http://dx.doi.org/10.1111/anae.15742
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