Isolated hip fracture care in an inclusive trauma system: A trauma system wide evaluation

Injury
J J E M van LaarhovenE J M M Verleisdonk

Abstract

Elderly patients with a hip fracture represent a large proportion of the trauma population; however, little is known about outcome differences between different levels of trauma care for these patients. The aim of this study is to analyse the outcome of trauma care in patients with a hip fracture within our inclusive trauma system. Retrospective cohort study. Data were collected from the electronic patient documentation of patients, with an isolated hip fracture (aged ≥ 60), admitted to a level I or level II trauma centre between January 2008 and December 2012. Main outcomes were time to operative treatment, complications, mortality, and secondary surgical intervention rate. A total of 204 (level I) and 1425 (level II) patients were admitted. Significantly more ASA4 patients, by the American Society of Anesthesiologists (ASA) classification, were treated at the level I trauma centre. At the level II trauma centre, median time to surgical treatment was shorter (0 days; IQR 0-1 vs 1 day; IQR 1-2; P < 0.001), which was mainly influenced by postponement due to lack of operation room availability (14%, n = 28) and co-morbidities (13%, n = 26) present at the level I trauma centre. At the level II trauma centre, hospital stay was shor...Continue Reading

References

Sep 3, 2003·Injury·Henk Jan ten Duis, Chris van der Werken
Mar 3, 2005·The Journal of Bone and Joint Surgery. American Volume·Christopher G MoranAndrew M Taylor
Oct 15, 2009·JAMA : the Journal of the American Medical Association·Carmen A BrauerAllison B Rosen
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Jan 24, 2014·JAMA Surgery·Kazuhide MatsushimaDavid I Soybel
Sep 19, 2014·World Journal of Orthopedics·Pedro CarpinteroManuel Mesa

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Citations

Mar 15, 2016·Medical Care·David MetcalfeAli Salim
Apr 24, 2018·World Journal of Emergency Surgery : WJES·F S WürdemannF Hietbrink
Nov 25, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Falco HietbrinkLoek P H Leenen
Oct 2, 2020·The Journal of Trauma and Acute Care Surgery·Darwin AngMatthew Carrick

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