title: Annual review of fractured neck of femur mortality rates: is this a true picture?
abstract: BACKGROUND
  Annual fractured neck of femur death rates within a region are used by the Department of Health (DoH) as a clinical performance indicator of hospital trusts. Presently trusts and DoH publish performance figures annually but there is significant variability year to year.
  
  
  OBJECTIVE
  Does a 5-year mortality review reflect a truer picture?
  
  
  METHODS
  Hospital information services were used to provide the details for all patients who died within 30 days of admission. These were analysed to determine the true fractured neck of femur mortality.
  
  
  RESULTS
  The variations in fractured neck of femur mortality rates between years within the same and between different trusts shows that annual scrutiny is an inappropriate, often skewed, analysis of performance.
  
  
  CONCLUSIONS
  A 5-year mortality review would seem more appropriate to visualise true trends and should be performed to remove anomalous results.
authors.affiliation: Department of Orthopaedic Surgery, Wythenshawe Hospital, Manchester, UK. nile.allaf@ntlworld.com
authors.forename: Nile
authors.initials: N
authors.lastname: Allaf
authors.forename: Martyn
authors.initials: M
authors.lastname: Lovell
mesh_terms: D004739:England / Q000453:epidemiology; D005265:Femoral Neck Fractures / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015996:Survival Rate