Abstract
Most health services in the United Kingdom provide unacceptable in-hospital care for hip fracture patients. We describe the impact on surgical delay following the introduction of an orthogeriatrician and the addition of one extra trauma list per week at our centre. Prospective data were collected on 101 consecutive patients followed by a second cohort of 105 patients. Mean time to surgery in cohorts 1 and 2 was 4.08 and 4.05 days, respectively (p = 0.71). Diagnosis of medical comorbidity increased with input from the orthogeriatrician from 69.7% to 74.2% (p = 0.24). Length of stay and mortality were comparable in the two groups. A full trauma list accounted for the most frequent orthopaedic delay, which decreased from 18.1% to 12.9% (p = 0.09). Increased recognition of medical comorbidity has financial implications for hospital remuneration. However, lack of orthopaedic provisions accounts for significant avoidable surgical delay requiring further investment if national standards are to be achieved.
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Acknowledgements
The authors thank the trauma nurse practitioners Jenny Currie and Lorraine Sanderson at Chesterfield Royal Hospital for their valued assistance in data collection during the study.
No financial support was received as part of this study
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The authors declare that they have no conflict of interest.
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Marsland, D., Chadwick, C. Prospective study of surgical delay for hip fractures: impact of an orthogeriatrician and increased trauma capacity. International Orthopaedics (SICOT) 34, 1277–1284 (2010). https://doi.org/10.1007/s00264-009-0868-0
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DOI: https://doi.org/10.1007/s00264-009-0868-0