Are hip fracture patients with high or low body mass index at higher risk of missed care? A cohort study.
Nanna Sofie Astrup Pedersen, Inger Mechlenburg, Pia Kjaer Kristensen
PMID 36815585WHAT IT FOUND
Underweight and overweight hip fracture patients had the same risk of missed guideline care as normal-weight patients.
Obese patients had lower fulfilment of surgery within 36 hours. Patients with missing BMI had the lowest care fulfilment.
Key findings
01Underweight and overweight patients had the same risk of missed care as normal-weight patients; the absolute differences were 2% for underweight and 1% for overweight.
02Obese patients had lower fulfilment of surgery within 36 hours than normal-weight patients, 82% versus 85%, with a relative risk of 0.85 and a 95% confidence interval of 0.72 to 0.998.
03Patients with missing BMI data had the lowest fulfilment of care processes, ranging from 22% to 90%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is an observational registry study, so it cannot show that BMI caused missed care. Routine data can misclassify care processes, although the registry has auditing. Hospital staff decided whether some patients were ineligible for mobilization, mobility assessment, prophylaxis, or rehabilitation planning, and that judgment may vary. Patients who died during admission were not analysed for discharge-related processes. The main regression did not adjust for covariates. Patients with missing BMI data were handled by statistical imputation, so some results depend on modelled values.
Declared interests
The authors report no conflicts of interest, and the research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
The easy way to misread this
Do not conclude that recording BMI prevents missed care. The study found that patients with missing BMI data had lower care fulfilment, but this is an association in registry data, not proof that BMI documentation caused better care.