Research Article
Volume 13 Issue 3 - 2022
Prioritising Treatment of High-Risk Patients with Neck of Femur Fractures Can Improve Outcomes
Shafat Gangoo* and Steven Cutts
Department of Trauma and Orthopaedics, James Paget University Hospital, UK
*Corresponding Author: Shafat Gangoo, Department of Trauma and Orthopaedics, James Paget University Hospital, UK.
Received: January 16, 2022; Published: February 28, 2022




Abstract

Background: As we are living longer the number of hip fractures in the elderly population is increasing. This has resulted in significant costs to health and social care systems around the world. By 2050 the number of hip fractures is projected to reach 4.5 million. In UK alone the cost of medical and social care costs related to hip fracture is around £2 billion annually.

Objective of the Study: The objective of the study was to analyse patient characteristics, evaluate time from admission to surgery, reasons for delay in surgery, average Length of stay (LOS), in hospital mortality, one- and three-year mortality rates for hip fractures in elderly people.

Methods: We prospectively studied case record of patients with fractured neck of femur aged over 65 years admitted to a self-contained hospital over a twelve-month period. Patient characteristics gathered included: age, sex, mental state, mobility status, ASA grading, type of fracture, surgical intervention, length of stay in hospital, destination at discharge and mortality rate. Patient information was collected at admission to hospital, at discharge and after one and four years respectively.

Result: 227 patients with hip fracture were admitted in the 12-month study period. 190 consecutive patients were analysed during the study period. Mean age was 78 years (Range 65 - 99). 133 (77%) were female and 57 (33%) were males. Mean time for admission from Emergency Department to Orthopaedic ward 3.10 hours (range ½ hour to 23 hrs). 145 (76.3%) were operated within 48 hours of admission to the hospital. The mean length of stay (LOS) on Orthopaedic trauma ward was 11 days. Mortality at 30 days was 9.45% (18/190). 94.44% of the deaths were in patients above 80 years with ASA 3 and above. Of the patients who died 50% (9/18) were operated after 48 hrs of admission to the hospital.

Conclusion: Advanced age, high ASA status, coupled with delayed surgery are associated with higher mortality in neck of femur fractures. Resources should be directed at optimising patients for early surgical intervention.

 

Keywords: Neck; Femur Fractures; Length of Stay (LOS); Hip Fractures

References

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Citation: Shafat Gangoo and Steven Cutts. “Prioritising Treatment of High-Risk Patients with Neck of Femur Fractures Can Improve Outcomes”. EC Orthopaedics 13.3 (2022): 37-42.

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