Early mortality after surgical fixation of hip fractures in the elderly: an analysis of data from the scottish hip fracture audit.
We investigated the relationship between a number of patient and management variables and mortality after surgery for fracture of the hip. Data relating to 18,817 patients were obtained from the Scottish Hip Fracture Audit database. We divided variables into two categories, depending on whether they were case-mix (age; gender; fracture type; pre-fracture residence; pre-fracture mobility and ASA scores) or management variables (time from fracture to surgery; time from admission to surgery; grade of surgical and anaesthetic staff undertaking the procedure and anaesthetic technique). Multivariate logistic regression analysis showed that all case-mix variables were strongly associated with post-operative mortality, even when controlling for the effects of the remaining variables. Inclusion of the management variables into the case-mix base regression model provided no significant improvement to the model. Patient case-mix variables have the most significant effect on post-operative mortality and unfortunately such variables cannot be modified by pre-operative medical interventions.
Holt
G
G
Department of Orthopaedic and Trauma Surgery, Hairmyres Hospital, Eaglesham Road, East Kilbride G75 8RG, UK. graemeholt@btinternet.com
Smith
R
R
Duncan
K
K
Finlayson
D F
DF
Gregori
A
A
D000368:Aged; D000369:Aged, 80 and over; D054869:Clinical Audit; D004812:Epidemiologic Methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000401:mortality*; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000401:mortality* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D011788:Quality of Life / Q000523:psychology; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D016896:Treatment Outcome