title: The effectiveness of orthopaedic trauma theatres in decreasing morbidity and mortality: a study of 701 displaced subcapital hip fractures in two trauma centres.
abstract: In countries with universal health care systems patients frequently wait days for their "emergency" surgery. A general trend in orthopaedic traumatology is the advent of daily, dedicated orthopaedic trauma theatres. Availability of trauma theatres is believed to decrease morbidity and mortality, but this remains unproven. A retrospective review comparing morbidity and mortality outcomes between two similar level-one trauma centres (one without a dedicated trauma room system) was undertaken. We reviewed 701 elderly patients receiving hemiarthroplasties for displaced subcapital hip fractures over a 76-month period. Patients were similar between centres in terms of age, gender ratio and comorbidities. Statistically significant differences were found favouring the dedicated trauma room system with approximately half the operative delay and post-operative morbidity. A trend towards decreased mortality was also seen. This study supports the use of regular orthopaedic trauma theatres in tertiary care institutions.
authors.affiliation: Sault Area Hospitals, Queen Street, East Sault Ste. Marie, Ont., Canada.
authors.forename: G M
authors.initials: GM
authors.lastname: Elder
authors.forename: E J
authors.initials: EJ
authors.lastname: Harvey
authors.forename: R
authors.initials: R
authors.lastname: Vaidya
authors.forename: P
authors.initials: P
authors.lastname: Guy
authors.forename: R N
authors.initials: RN
authors.lastname: Meek
authors.forename: M
authors.initials: M
authors.lastname: Aebi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000401:mortality; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D009873:Operating Rooms; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014504:Urban Health
chemical_list: D000890:Anti-Infective Agents