Justin Zeltzer1, Rebecca J Mitchell2, Barbara Toson2, Ian A Harris3, Laura Ahmad4, Jacqui Close2. 1. Falls and Injury Prevention Group, Neuroscience Research Australia, Sydney, NSW, Australia. r.mitchell@unsw.edu.au. 2. Falls and Injury Prevention Group, Neuroscience Research Australia, Sydney, NSW, Australia. 3. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia. 4. Aged Health Network, Agency for Clinical Innovation, Sydney, NSW, Australia.
Abstract
OBJECTIVE: To examine the impact of orthogeriatric services on 30-day mortality and length of stay (LOS) for hip fracture patients undergoing surgery in public hospitals in New South Wales. DESIGN, SETTING AND PATIENTS: A retrospective analysis of patients aged 65 years and older who had a fractured hip and received surgical intervention between 1 July 2009 and 30 June 2011 at one of the 37 NSW public hospitals operating on hip fracture patients. MAIN OUTCOME MEASURES: 30-day mortality and LOS. RESULTS: During the study period, there were 9601 hip fracture cases for which surgery was done. Mean age, sex and comorbidity distribution were similar for hip fracture patients treated in hospitals with an orthogeriatric service compared with those treated in hospitals without an orthogeriatric service. There were 706 deaths within 30 days of hip fracture surgery, and the overall unadjusted 30-day mortality rate was 7.4%. The median adjusted 30-day mortality rate for hospitals with an orthogeriatric service was significantly lower than that for hospitals without an orthogeriatric service (6.2% v 8.4%; P < 0.002). Median total LOS was longer at hospitals with an orthogeriatric service compared with hospitals that did not have an orthogeriatric service (26 days v 22 days; P < 0.001). CONCLUSIONS: The presence of an orthogeriatric service was associated with a reduction in 30-day mortality but a longer LOS. More research is required to understand the key aspects of care that determine health outcomes. The recently launched Australian and New Zealand Hip Fracture Registry will provide data that will enable improvements in care.
OBJECTIVE: To examine the impact of orthogeriatric services on 30-day mortality and length of stay (LOS) for hip fracturepatients undergoing surgery in public hospitals in New South Wales. DESIGN, SETTING AND PATIENTS: A retrospective analysis of patients aged 65 years and older who had a fractured hip and received surgical intervention between 1 July 2009 and 30 June 2011 at one of the 37 NSW public hospitals operating on hip fracturepatients. MAIN OUTCOME MEASURES: 30-day mortality and LOS. RESULTS: During the study period, there were 9601 hip fracture cases for which surgery was done. Mean age, sex and comorbidity distribution were similar for hip fracturepatients treated in hospitals with an orthogeriatric service compared with those treated in hospitals without an orthogeriatric service. There were 706 deaths within 30 days of hip fracture surgery, and the overall unadjusted 30-day mortality rate was 7.4%. The median adjusted 30-day mortality rate for hospitals with an orthogeriatric service was significantly lower than that for hospitals without an orthogeriatric service (6.2% v 8.4%; P < 0.002). Median total LOS was longer at hospitals with an orthogeriatric service compared with hospitals that did not have an orthogeriatric service (26 days v 22 days; P < 0.001). CONCLUSIONS: The presence of an orthogeriatric service was associated with a reduction in 30-day mortality but a longer LOS. More research is required to understand the key aspects of care that determine health outcomes. The recently launched Australian and New Zealand Hip Fracture Registry will provide data that will enable improvements in care.
Authors: Charlotte Stenqvist; Christian Medom Madsen; Troels Riis; Henrik Løvendahl Jørgensen; Benn Rønnow Duus; Jes Bruun Lauritzen; Susanne van der Mark Journal: Geriatr Orthop Surg Rehabil Date: 2016-03-02
Authors: Samuel Hawley; M Kassim Javaid; Daniel Prieto-Alhambra; Janet Lippett; Sally Sheard; Nigel K Arden; Cyrus Cooper; Andrew Judge Journal: Age Ageing Date: 2016-01-21 Impact factor: 10.668