title: Mortality and morbidity of neck of femur fractures: A comparison between Orange and peripheral centres.
abstract: OBJECTIVE
  The aim of this study is to examine and compare the mortality and morbidity of patients with neck of femur (NOF) fracture who presented initially to either Orange Health Service (OHS), a secondary orthopaedic referral centre or to a peripheral hospital and subsequently transferred to OHS.
  
  
  METHODS
  This study is designed as a retrospective review of medical records of 151 patients with NOF fractures who were treated operatively between March 2013 and March 2014 at OHS. Patients were divided into OHS group and 'Other' group based on their initial presenting location.
  
  
  METHODS
  Mortality, unplanned intensive care unit/high dependency unit admissions, ischemic heart/cerebral events, infection rates and length of stay.
  
  
  RESULTS
  There was no statistically significant difference in mortality and morbidity proportions between both groups. There were significant differences between lengths of stay in the acute setting which was shorter in the 'Other' group.
  
  
  CONCLUSIONS
  Contrary to the literature, this study found that the morbidity and mortality outcomes of patients with NOF fracture who presented initially to rural hospitals were equivalent to those who presented to a secondary orthopaedic referral centre. However, those who first presented to rural hospitals had a shorter duration of stay in the acute setting.
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Marshall
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Mayuran
authors.initials: M
authors.lastname: Suthersan
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Mun Khin
authors.initials: MK
authors.lastname: Chan
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Jenkins
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Mingzhou
authors.initials: M
authors.lastname: Toh
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Giddins
authors.affiliation: Department of Orthopaedic Surgery, Orange Health Service, Orange, New South Wales, Australia.
authors.forename: Evan
authors.initials: E
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: NOF; morbidity; mortality; neck of femur; rural