title: Hip fracture surgery and performance indicators: an analysis of 941 patients operated in a large teaching hospital.
abstract: BACKGROUND
  In the Netherlands, two performance indicators for the treatment of hip fracture patients have been recently implemented. Both indicators state that surgery within 24 h after admission improves the outcome with regard to 1-year mortality and the amount of re-operations within 1 year. To determine the value of these performance indicators, we conducted a retrospective analysis of 941 hip fracture patients.
  
  
  METHODS
  In the period from January 2003 to December 2006, a total of 941 consecutive hip fracture patients were included in this study. We determined the amount of re-operations and the mortality at 1 year after surgery. From June 2005 to December 2006, we could determine whether patients were operated on within 24 h after admission. In this group of 379 patients, we determined if there were differences in the 1-year mortality and the number of re-operations at 1 year with regard to the time window in which these patients were operated on (<24 h or >24 h).
  
  
  RESULTS
  Our overall mortality rate at 1 year is 21% (202 patients) and the amount of re-operations within 1 year is 8% (77 procedures). In our subgroup analysis, we found no significant difference in mortality or re-operations if patients were operated on within 24 h or not (number needed to treat of 59 and -31, respectively).
  
  
  CONCLUSIONS
  We conclude that hip fracture surgery within 24 h does not provide significantly better results in terms of 1-year mortality and the amount of re-operations within 1 year.
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
authors.forename: T S C
authors.initials: TS
authors.lastname: Jakma
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Vijfhuize
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: Vegt
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: Plaisier
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
authors.forename: R J
authors.initials: RJ
authors.lastname: Oostenbroek
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands. b.j.punt@asz.nl.
authors.forename: B J
authors.initials: BJ
authors.lastname: Punt
keywords: Hip fracture; Mortality; Performance indicator; Re-operation
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