title: [Proximal femoral fractures in the German external quality assurance module 17/1: reasons for delay in surgery].
abstract: BACKGROUND
  For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given.
  
  
  METHODS
  Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission.
  
  
  RESULTS
  A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission. Reasons were pathological bleeding, preoperative poor general condition, lack of informed consent, intake of metformin and lacking initial radiological detection of fractures. Due to a lack of software-related specifications in ten patients a wrong preoperative length of stay was generated.
  
  
  CONCLUSIONS
  The significance of the quality indicator "preoperative stay" without division into whether this was administrative or patient-related must be considered critically. For fall-related fractures in hospital the time of the accident or diagnosis should be considered.
authors: Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Strasse 1, 67655, Kaiserslautern, Deutschland. thomas@ruffing.eu
authors: T
authors: T
authors: Ruffing
authors: D
authors: D
authors: Klein
authors: P
authors: P
authors: Huchzermeier
authors: H
authors: H
authors: Winkler
authors: M
authors: M
authors: Muhm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D057234:Preoperative Period; D015995:Prevalence; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D014850:Waiting Lists; D055815:Young Adult
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