title: Predictors of outcome following hip fracture. Admission time predicts length of stay and in-hospital mortality.
abstract: Many factors may contribute to the mortality and morbidity following hip fracture, including the provision of care. We wished to examine the contribution of potential factors to in-hospital mortality, length of hospital stay and 90-day mortality by statistical analyses of an audit database of all hip fractures admitted to a teaching hospital following the introduction of a fast track admission system. In-hospital mortality was predicted by ASA grade, the presence of any complications, cardiovascular complications, grade of surgeon, operation type and shorter admission time, a measure of time taken to admit a patient to a hospital bed (P<0.001). Length of hospital stay was predicted by increased age, presence of chronic cognitive impairment/dementia, presence of an implant complication, operation type, fracture type and longer admission time, r=0.455, P<0.001. Ninety-day mortality was predicted by the presence of chronic cognitive impairment/dementia, cardiovascular complications, pulmonary complications, ASA grade, grade of surgeon and admission day, P<0.001. Rapid admission following a hip fracture may not be the ideal management approach for all patient groups. Further study is required to identify factors in the process of care which are associated with better outcomes.
authors.affiliation: Clinical Division 1, University of Manchester, Manchester, UK.
authors.forename: John E
authors.initials: JE
authors.lastname: Clague
authors.forename: Elaine
authors.initials: E
authors.lastname: Craddock
authors.forename: Glynn
authors.initials: G
authors.lastname: Andrew
authors.forename: Michael A
authors.initials: MA
authors.lastname: Horan
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D010343:Patient Admission; D011183:Postoperative Complications; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome