BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall, infection or suboptimal surgery, stratified into either requiring reoperation or not allowing mobilisation because of instability. RESULTS: Of the 600, 116 (19.3, 95% CI 16-22%) patients underwent reoperation or immobilisation; 27.1% of bed-day consumption resulted from surgical complications. The audit showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause. CONCLUSION: Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50% of these hospital days might be spared by optimal surgery.
BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall, infection or suboptimal surgery, stratified into either requiring reoperation or not allowing mobilisation because of instability. RESULTS: Of the 600, 116 (19.3, 95% CI 16-22%) patients underwent reoperation or immobilisation; 27.1% of bed-day consumption resulted from surgical complications. The audit showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause. CONCLUSION: Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50% of these hospital days might be spared by optimal surgery.
Authors: Halima Amer; Frances Dockery; Nicholas Barrett; Marc George; Karolina Witek; Jeremy Stanton; Diane Back Journal: BMJ Case Rep Date: 2011-07-20
Authors: Anne J H Vochteloo; Elvira R Flikweert; Wim E Tuinebreijer; Andrea B Maier; Rolf M Bloem; Peter Pilot; Rob G H H Nelissen Journal: Int Orthop Date: 2013-01-16 Impact factor: 3.075
Authors: Henrik Palm; Michael Krasheninnikoff; Kim Holck; Tom Lemser; Nicolai Bang Foss; Steffen Jacobsen; Henrik Kehlet; Peter Gebuhr Journal: Acta Orthop Date: 2012-01-17 Impact factor: 3.717
Authors: Anne J H Vochteloo; Sabine T van Vliet-Koppert; Andrea B Maier; Wim E Tuinebreijer; Maarten L Röling; Mark R de Vries; Rolf M Bloem; Rob G H H Nelissen; Peter Pilot Journal: Arch Orthop Trauma Surg Date: 2012-02-07 Impact factor: 3.067