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Title: Hip fracture : a study of the factors influencing thromboembolic complications and mortality
Author: Mackenzie, Douglas Graham
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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Aim: To explore the effect of different types of thromboprophylaxis (TP) in hip fracture patients after adjusting for cofactors and comorbidities. Data sources: Prospectively collected Scottish Hip Fracture Audit (SHFA) data, linked to routinely collected Scottish Morbidity Records (SMR) providing information about hospital discharges, mortality records and cancer registry data. Participants: 8470 patients aged 60 years and over admitted to NHS hospitals in Scotland with hip fracture (1998 to 2003). Methods: Multivariate analysis (Cox proportional hazards regression analysis), adjusting for SHFA variables (including age, sex, residence pre-fracture, American Society of Anaesthesiologists grade, delay to surgery for medical reasons, hospital, and type of TP received), and SMR variables (including the Scottish Index of Multiple Deprivation, number of hospital admissions in the five years prior to hip fracture, previous diagnoses with cardiovascular disease or respiratory disease, or cancer registration). Main results: The mortality rate in the year following hip fracture was 30% (95% CI 29 to 31%). Clinically identified TED was uncommon in the year following hp fracture with 1.4% (95% CI to 1.2 to 1.7%) patients recorded as having a hospital episode with a primary diagnosis of TED and 0.3% (95% 0.2 to 0.4%) patients recorded with TED as the primary cause of death. There was evidence of reduced mortality in patients documented as receiving aspirin or graduated elasticated compression (GEC) stockings, but there was no statistically significant effect on combined admissions/deaths from TED or coronary artery disease with aspirin or GEC stockings. Heparin did not have a statistically significant influence on outcomes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available