T Ruffing1, D Klein, P Huchzermeier, H Winkler, M Muhm. 1. Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Strasse 1, 67655, Kaiserslautern, Deutschland. thomas@ruffing.eu
Abstract
BACKGROUND: For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given. MATERIALS AND METHODS: Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission. RESULTS: A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission. Reasons were pathological bleeding, preoperative poor general condition, lack of informed consent, intake of metformin and lacking initial radiological detection of fractures. Due to a lack of software-related specifications in ten patients a wrong preoperative length of stay was generated. CONCLUSION: The significance of the quality indicator "preoperative stay" without division into whether this was administrative or patient-related must be considered critically. For fall-related fractures in hospital the time of the accident or diagnosis should be considered.
BACKGROUND: For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given. MATERIALS AND METHODS: Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission. RESULTS: A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission. Reasons were pathological bleeding, preoperative poor general condition, lack of informed consent, intake of metformin and lacking initial radiological detection of fractures. Due to a lack of software-related specifications in ten patients a wrong preoperative length of stay was generated. CONCLUSION: The significance of the quality indicator "preoperative stay" without division into whether this was administrative or patient-related must be considered critically. For fall-related fractures in hospital the time of the accident or diagnosis should be considered.