Length of stay, wait time to surgery and 30-day mortality for patients with hip fractures after the opening of a dedicated orthopedic weekend trauma room.
BACKGROUND
In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures.


METHODS
Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room. We documented type of fracture, mode of fixation, age, sex, American Society of Anesthesiologists (ASA) score, time to OR, LOS, discharge disposition and 30-day mortality. We excluded patients with multiple fractures, open fractures and those requiring trauma team activation.


RESULTS
Our study included 609 patients (405 pre- and 204 post-trauma room opening). Mean LOS decreased from 11.6 to 9.4 days (p = 0.005) and there was a decreasing trend in mean time to OR from 31.5 to 28.5 hours (p = 0.16). There was no difference in 30-day mortality (p = 0.24). The LOS decreased by an average of 2 days following opening of the weekend trauma room (p = 0.031) and by an average of 2.2 additional days if the patient was admitted on the weekend versus during the week (p = 0.024).


CONCLUSIONS
The weekend trauma OR at KGH significantly decreased the LOS and appears to have decreased wait times to surgery. Further analysis is needed to assess the cost-effectiveness of the current strategy, the long-term outcome of this patient population and the impact the additional orthopedic weekend trauma room has had on other surgical services (i.e., general surgery) and their patients.
From the Department of Orthopedic Surgery, Queen's University, Kingston, Ont. (Taylor, Yach); the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Hopman); and the Kingston General Hospital Research Institute, Kingston, Ont. (Hopman).
Michel
M
Taylor
From the Department of Orthopedic Surgery, Queen's University, Kingston, Ont. (Taylor, Yach); the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Hopman); and the Kingston General Hospital Research Institute, Kingston, Ont. (Hopman).
Wilma
W
Hopman
From the Department of Orthopedic Surgery, Queen's University, Kingston, Ont. (Taylor, Yach); the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Hopman); and the Kingston General Hospital Research Institute, Kingston, Ont. (Hopman).
Jeff
J
Yach
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005592:Fracture Fixation / Q000401:mortality / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D055815:Young Adult
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