Author(s): Harrison E.L.; Naraen S.
Source: Osteoporosis International; 2017; vol. 28
Publication Date: 2017
Publication Type(s): Conference Abstract
Abstract:Objectives: It is well recognised that fractured neck of femurs (NOFs) are often terminal events. This study compares 30 day mortality for inpatients following hip fracture at a trauma centre to both national and pre-regular orthogeriatrician input. It looks at causes of death and the impact regular orthogeriatrician review had on this including length of stay (LOS). Material and Methods: Data was collected from local hip fracture and bereavement office databases for both LOS and mortality. Hip fracture ward LOS was collected for 2013 and 2015. Mortality data was collected for two periods; October 2010-September 2011 and November 2014-December 2015, which was then compared to national hip fracture database figures. Results: In October 2010-September 2011, there were 24 deaths from a total 343 fractured NOFs (7. 00%; national average 8.0%1) with an average time until death of 10.66 days. In November 2014-Oct 2015, there were 34 deaths from a total 480 fractured NOFs (7. 01%; national average 7.5%2) with an average time of death of 8.24 days. There was also a statistically significant difference in pre-morbid status; in the first study period the ASA grade was 2.81 compared to 2.95 (students T-test 0.002). This was reflected in the AMTS; in October 2010-September 2011 it was 6.93 compared to 8.05 in November 2014-October 2015. This was also statistically significant (<0. 0001). Most deaths had medical origins with pneumonia remaining the most common. When looking at LOS the mean in 2013 was 25 days compared to 20 days in 2015. Conclusion: Mortality rates were below the national average in both periods examined along with improved LOS. There was a more widespread cause of death in 2015 reflecting patients having more complex co-morbidities, and also the regular dedicated orthogeriatrician service, which provides daily reviews. These in-depth reviews allow earlier recognition of any medical problems, thereby minimising potentially avoidable causes of death and helping to reduce LOS. The regular orthogeritrician also provides a much valued link to rehabilitation services.