National Hip Fracture Database Annual Report 2017

Hip fracture is a serious and costly injury affecting mainly older people, and is more common in women. It usually results from the combination of weak bone structure (osteoporosis) and a fall. Around 76,000 hip fractures occur each year in the UK as a whole. Although there is good evidence on best practice in surgical, medical and rehabilitation care following hip fracture, such care and its outcomes – in terms of return home and also of mortality – continues to vary.

The National Hip Fracture Database (NHFD), which was launched in 2007, aims to deliver improvements in the care of hip fracture patients. It documents case-mix, care and outcomes of hip fracture patients in England, Wales and Northern Ireland and is now, with more than 250,000 cases on record – by far the largest hip fracture audit in the world.

It has demonstrated broad improvements at local and national level in patient care, and in England has supported the Department of Health’s highly successful Best Practice Tariff for hip fracture care. The work of the NHFD is now being replicated in Ireland, with the recent launch of Irish Hip Fracture Database, and similar developments are in hand in Australia and New Zealand, Canada and Hong Kong.

The National Hip Fracture Database was founded as a collaboration between the British Orthopaedic Association and the British Geriatrics Society. It was developed between 2004 and 2007, and since 2009 it has received central funding as a national clinical audit via the Healthcare Quality Improvement Partnership (HQIP). Since April 2012 the NHFD has continued as part of the Falls and Fragility Fracture Audit Programme, managed on behalf of HQIP by the Royal College of Physicians (London).

The audit covers England, Wales, Northern Ireland and the Isle of Man and, however data files only refer to data for England and Wales

股骨颈骨折是一种严重且代价高昂的损伤，主要影响老年人，且在女性中更为常见。该损伤通常由薄弱的骨骼结构（骨质疏松症）与跌倒的共同作用所致。在英国，每年约有76,000例股骨颈骨折发生。尽管关于股骨颈骨折后最佳手术、医疗和康复护理的证据充分，但此类护理及其结果——无论是在回家能力还是死亡率方面——仍存在较大差异。

国家股骨颈骨折数据库（NHFD）于2007年启动，旨在提升股骨颈骨折患者的护理水平。该数据库记录了英格兰、威尔士和北爱尔兰的股骨颈骨折患者的病例组合、护理过程和结果，目前已有超过250,000例病例记录，堪称世界上最大的股骨颈骨折审计项目。

NHFD已在地方和国家级别上展现了患者护理的广泛改进，并在英格兰支持了卫生部门成功实施的股骨颈骨折最佳实践收费标准。NHFD的工作现已在爱尔兰复制，近期爱尔兰股骨颈骨折数据库的启动，以及类似的进展正在澳大利亚、新西兰、加拿大和香港进行。

国家股骨颈骨折数据库由英国骨科协会和英国老年病学会合作创立。它于2004年至2007年开发，自2009年以来，作为国家临床审计项目，通过医疗保健质量改进伙伴关系（HQIP）获得中央资金支持。自2012年4月起，NHFD作为跌倒和脆性骨折审计项目的一部分继续运行，该项目由伦敦的皇家医学院代表HQIP管理。

审计范围包括英格兰、威尔士、北爱尔兰和马恩岛，尽管数据文件仅涉及英格兰和威尔士的数据。