Variations in treatment of femoral neck fractures in Alberta.
OBJECTIVE
To examine, in the province of Alberta, temporal trends, regional variations in treatment options and in-hospital death rates after a femoral neck fracture.


METHODS
A retrospective cohort study.


METHODS
Six years' data were abstracted from the Alberta Morbidity File, the Alberta Health Stakeholder File and the Alberta Health Care Claims File. Patients were included if they were Alberta residents, aged 65 years or older, had sustained a femoral neck fracture and had undergone internal fixation, hemiarthroplasty or total hip arthroplasty.


METHODS
Death rates, arthroplasty rates and hospital stay.


RESULTS
In-hospital death rates were similar across hospitals, with risks being higher for men, patients aged 80 years or older and those with more comorbid conditions. Arthroplasty rates varied from 58% to 77% among hospitals, and hospital stays associated with arthroplasty were significantly longer than those associated with internal fixation. The chance of undergoing arthroplasty varied from hospital to hospital by gender and by the number of comorbid conditions.


CONCLUSIONS
Regional variations suggest lack of agreement among Alberta's surgeons as to how best to treat femoral neck fractures.
Cree
Marilyn
M
Department of Mathematical Sciences, University of Alberta, Edmonton.
Yang
Qian
Q
Scharfenberger
Angela
A
Johnson
David
D
Carrière
K C
KC
D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies