{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:04:00Z","timestamp":1787061840482,"version":"build-2736575974"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Hintergrund Die h\u00e4ufig multimorbiden, geriatrisch-unfallchirurgischen Patienten mit h\u00fcftgelenknaher Femurfraktur bed\u00fcrfen als Notfallpatienten einer m\u00f6glichst fr\u00fchzeitigen operativen und interdisziplin\u00e4ren Behandlung, um Komplikationen (Morbidit\u00e4t, \u201emorbidity\u201c) und die Sterblichkeit (Mortalit\u00e4t, \u201emortality\u201c) zu reduzieren. Die pr\u00e4operative Verweildauer ist ein sensibler und multifaktorieller Qualit\u00e4tsindikator (QI) des Behandlungsgeschehens. Aufgrund von fortbestehenden Auff\u00e4lligkeiten dieses QI in der externen station\u00e4ren Qualit\u00e4tssicherung (esQS) in Deutschland wurde vom Institut f\u00fcr Qualit\u00e4tssicherung und Transparenz im Gesundheitswesen (IQTIG) und vom Gemeinsamen Bundesausschuss (G-BA) weiterhin \u201ebesonderer Handlungsbedarf\u201c f\u00fcr diesen Indikator konstatiert (IQTIG Qualit\u00e4tsreport 2019).<\/jats:p>\n                  <jats:p>Ziel der Arbeit Identifizierung von methodisch besonders belastbaren Empfehlungen zu strukturellen und prozessualen Standards zur Sicherstellung einer angemessenen klinischen Versorgung.<\/jats:p>\n                  <jats:p>Methoden Systematische internationale webbasierte Recherche und Analyse relevanter Leitlinien nach der Dom\u00e4ne 3 des AGREE-II-Instruments; Extraktion einzelner methodisch gesicherter Empfehlungen; Erg\u00e4nzung der Leitlinienanalyse um eine Beurteilung von Regelwerken mit Struktur und Prozessanforderungen bzw. Kriterien f\u00fcr Qualit\u00e4ts- und Versorgungsstandards.<\/jats:p>\n                  <jats:p>Ergebnisse Von insgesamt 66 identifizierten, kontextrelevanten Leitlinien wurden 15 mit \u201emethodisch hochwertig\u201c bewertet. Besonders belastbare Empfehlungen aus diesen 15 Leitlinien ergaben sich unter anderem zu den Handlungsfeldern Operationstechnik, Orthogeriatrie, Antibiotikaprophylaxe, Dekubitus- und Thromboembolieprophylaxe, Operationszeitpunkt, An\u00e4sthesie, Physiotherapie, postoperatives Management und Delir. Aus 9 weiteren Regelwerken lie\u00dfen sich spezielle strukturelle und prozessuale Vorgaben extrahieren.<\/jats:p>\n                  <jats:p>Schlussfolgerung Fr\u00fchzeitige Operation und angemessene Versorgung sind durch ein konsequent multifaktoriell abgestimmtes, verbindliches Vorgehen in ad\u00e4quat strukturell und prozessual ausgerichteten, interdisziplin\u00e4r arbeitenden Einrichtungen zu gew\u00e4hrleisten.<\/jats:p>","DOI":"10.1055\/a-1312-6596","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T19:06:46Z","timestamp":1610737606000},"page":"935-943","source":"Crossref","is-referenced-by-count":3,"title":["Zur h\u00fcftgelenknahen Femurfraktur des erwachsenen Menschen \u2013 Zeitgem\u00e4\u00dfes klinisches Management auf der Basis internationaler Standards"],"prefix":"10.1055","volume":"84","author":[{"given":"Christian","family":"Kralewski","sequence":"additional","affiliation":[{"name":"Kompetenz-Centrum Qualit\u00e4tssicherung\/Qualit\u00e4tsmanagement (KCQ), Medizinischer Dienst der Krankenversicherung Baden-W\u00fcrttemberg, T\u00fcbingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gaertner","sequence":"additional","affiliation":[{"name":"Sozialmedizinisches Wissens- und Qualit\u00e4tsmanagement, Medizinischer Dienst der Krankenversicherung Hessen, Oberursel, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Giehl","sequence":"additional","affiliation":[{"name":"ehem. Kompetenz-Centrum Qualit\u00e4tssicherung\/Qualit\u00e4tsmanagement (KCQ), Medizinischer Dienst der Krankenversicherung Baden-W\u00fcrttemberg, T\u00fcbingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Gleisberg","sequence":"additional","affiliation":[{"name":"Abteilung Medizin, Referat Qualit\u00e4tssicherung, GKV-Spitzenverband, Berlin, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Smektala","sequence":"additional","affiliation":[{"name":"Unfallchirurgie und Orthop\u00e4die, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Goldmund","family":"Korbmacher","sequence":"additional","affiliation":[{"name":"Unfallchirurgie und Orthop\u00e4die, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s00198-012-2020-z","article-title":"The health burden and costs of incident fractures attributable to osteoporosis from 2010 to 2050 in Germany \u2013 a demographic simulation model","volume":"24","author":"F Bleibler","year":"2013","journal-title":"Osteoporos Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00132-019-03723-8","article-title":"Der geriatrische Patient in der Orthop\u00e4die","volume":"48","author":"K Fischer","year":"2019","journal-title":"Der Orthop\u00e4de"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1055\/s-0042-116970","article-title":"H\u00fcftgelenknahe Frakturen\/Luxationen","volume":"12","author":"F Bonnaire","year":"2017","journal-title":"Orthop\u00e4die und Unfallchirurgie up2date"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s00113-012-2295-8","article-title":"Mediale Schenkelhalsfraktur: m\u00f6gliche Gr\u00fcnde f\u00fcr eine verz\u00f6gerte operative Versorgung","volume":"117","author":"R Smektala","year":"2014","journal-title":"Der Unfallchirurg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.ypmed.2010.08.005","article-title":"AGREE II: advancing guideline development, reporting, and evaluation in health care","volume":"51","author":"M C Brouwers","year":"2010","journal-title":"Prev Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1302\/0301-620x.97b3.34504","article-title":"The determinants of mortality and morbidity during the year following fracture of the hip: a prospective study","volume":"97-b","author":"M Mariconda","year":"2015","journal-title":"Bone Joint J"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s00113-011-2071-1","article-title":"Einfluss des Operationszeitpunkts und -verfahrens auf Mortalit\u00e4t und Fr\u00fchkomplikationen der Schenkelhalsfraktur","volume":"116","author":"T Kostuj","year":"2013","journal-title":"Der Unfallchirurg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.injury.2009.01.010","article-title":"Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients","volume":"40","author":"S K Khan","year":"2009","journal-title":"Injury"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.2106\/jbjs.o.00029","article-title":"Time to Surgery Is Associated with Thirty-Day and Ninety-Day Mortality After Proximal Femoral Fracture: A Retrospective Observational Study on Prospectively Collected Data from the Danish Fracture Database Collaborators","volume":"97","author":"A M Nyholm","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1111\/j.1525-1497.2005.00219.x","article-title":"Best practices for elderly hip fracture patients. 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