title: Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network.
abstract: The aim of this audit was to investigate process, personnel and anaesthetic factors in relation to mortality among patients with proximal femoral fractures. A questionnaire was used to record standardised data about 1195 patients with proximal femoral fracture admitted to 22 hospitals contributing to the Hip Fracture Anaesthesia Network over a 2-month winter period. Patients were demographically similar between hospitals (mean age 81 years, 73% female, median ASA grade 3). However, there was wide variation in time from admission to operation (24-108 h) and 30-day postoperative mortality (2-25%). Fifty percent of hospitals had a mean admission to operation time < 48 h. Forty-two percent of operations were delayed: 51% for organisational; 44% for medical; and 4% for 'anaesthetic' reasons. Regional anaesthesia was administered to 49% of patients (by hospital, range = 0-82%), 51% received general anaesthesia and 19% of patients received peripheral nerve blockade. Consultants administered 61% of anaesthetics (17-100%). Wide national variations in current management of patients sustaining proximal femoral fracture reflect a lack of research evidence on which to base best practice guidance. Collaborative audits such as this provide a robust method of collecting such evidence.
authors.affiliation: Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. igasbest@hotmail.com
authors.forename: S M
authors.initials: SM
authors.lastname: White
authors.forename: R
authors.initials: R
authors.lastname: Griffiths
authors.forename: J
authors.initials: J
authors.lastname: Holloway
authors.forename: A
authors.initials: A
authors.lastname: Shannon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods* / Q000706:statistics & numerical data; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data; D002983:Clinical Competence; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008485:Medical Audit; D009407:Nerve Block / Q000706:statistics & numerical data; D013222:State Medicine / Q000706:statistics & numerical data; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology