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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 10, 1357-1363.
doi: 10.1302/0301-620X.90B10.21328  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Early mortality after surgical fixation of hip fractures in the elderly

AN ANALYSIS OF DATA FROM THE SCOTTISH HIP FRACTURE AUDIT

G. Holt, MBChB, MRCS, Specialist Registrar, Orthopaedic Surgery1; R. Smith, PhD, Head Statistician2; K. Duncan, MSc, BA, RGN, SHFA National Clinical Coordinator2; D. F. Finlayson, FRCS, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon3; and A. Gregori, FRCS, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon1

1 Department of Orthopaedic and Trauma Surgery, Hairmyres Hospital, Eaglesham Road, East Kilbride G75 8RG, UK.
2 Scottish Hip Fracture Audit Healthcare Information Group, Information Services Division NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK.
3 Department of Orthopaedic and Trauma Surgery, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, UK.

Correspondence should be sent to Mr G. Holt; e-mail: graemeholt{at}btinternet.com

We investigated the relationship between a number of patient and management variables and mortality after surgery for fracture of the hip. Data relating to 18 817 patients were obtained from the Scottish Hip Fracture Audit database. We divided variables into two categories, depending on whether they were case-mix (age; gender; fracture type; pre-fracture residence; pre-fracture mobility and ASA scores) or management variables (time from fracture to surgery; time from admission to surgery; grade of surgical and anaesthetic staff undertaking the procedure and anaesthetic technique).

Multivariate logistic regression analysis showed that all case-mix variables were strongly associated with post-operative mortality, even when controlling for the effects of the remaining variables. Inclusion of the management variables into the case-mix base regression model provided no significant improvement to the model. Patient case-mix variables have the most significant effect on post-operative mortality and unfortunately such variables cannot be modified by pre-operative medical interventions.




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Early mortality after surgical fixation of hip fractures in the elderly
Dr Sunil Gurpur Kini, et al.
J Bone Joint Surg Br Online, 16 Oct 2008 [Full text]

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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General