title: Auckland City Hospital's Ortho-Geriatric Service: an audit of patients aged over 65 with fractured neck of femur.
abstract: OBJECTIVE
  The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007.
  
  
  METHODS
  Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013.
  
  
  RESULTS
  Ninety-one patients were audited; mean age was 83 years, 68% were female. Both inpatient and 30-day mortality was 5%. 120-day mortality was 15%. Seventy-six percent of patients were admitted from ED within the national health target prescribed period of 6 hours. Only one patient was treated non-surgically. Eighty-six percent had surgery within 48 hours of admission. Eighty-two percent of patients had rehabilitation and treatment by Older People's Health. Of those living at home pre-fracture, 76% returned home on discharge. Thirty-seven percent of patients were able to walk unaided prior to hip fracture, but only 1% on discharge. Average overall length of stay was 22 days. Bisphosphonates were prescribed for 56% of patients.
  
  
  CONCLUSIONS
  Compared to 2007, Auckland City Hospital has demonstrated a significant improvement in the rate of provision of timely surgery for hip fracture patients. Most patients are receiving the guideline recommended fracture-specific surgical interventions. The assessment and treatment of osteoporosis needs further attention.
authors.affiliation: Older People's Health, Auckland City Hospital, Private Bag 92024, Auckland Mail Centre, Auckland 1142. bodhigw@yahoo.co.nz.
authors.forename: Bodhi
authors.initials: B
authors.lastname: Wimalasena
authors.forename: Roger
authors.initials: R
authors.lastname: Harris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D054869:Clinical Audit; D060825:Cognitive Dysfunction / Q000453:epidemiology; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology; D004164:Diphosphonates / Q000008:administration & dosage; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology* / Q000534:rehabilitation / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D062785:Hemiarthroplasty / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D009983:Orthopedic Equipment / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology; D012046:Rehabilitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D020246:Venous Thrombosis / Q000517:prevention & control
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D010975:Platelet Aggregation Inhibitors