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Causes of Surgical Delay and Demographic Characteristics in Patients with Hip Fracture

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DOI: 10.4236/ojo.2013.34035    3,786 Downloads   5,720 Views  

ABSTRACT

Background: Several studies analyze how surgical delay affects patients with hip fracture. The aim of this study was to identify the causes of surgical delay and demographic characteristics in patients with hip fracture who had delays longer than 24 hours from admission to hospital. Methods: Quantitative retrospective register study of 484 patients was consecutively included during the period November 1, 2010 and October 31, 2011 in the University Hospital in Lund (Sweden). Results: A frequency of 29.4% had a surgical delay longer than 24 hours. The main reasons for delays to surgery were lack of theatre facilities (54%), medical unstable patient (16%) and anticoagulant treatment (10%). Of all patients, 69% (n = 332) were women and 31% (n = 151) were men. The mean age for women were 83.6 (CI 83-85) vs. 79 (CI 77-81) for men, respectively. The most common type of hip fracture was displaced cervical hip fracture (39%, n = 188) with a majority of fractures in male patients. In total, women suffered hip fractures to a greater extent than men (69% vs. 31%, p = 0.016), but no relationship was found with respect to the fracture type and age (p = 0.358). Conclusion: The main result demonstrated that delays longer than 24 hours were due to lack of theatre facilities. Further researches have to be done in order to investigate whether lack of theatre facilities depends on improper operation planning and/or on lack of medical staff.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

S. Desirée, H. Ami and J. Anders, "Causes of Surgical Delay and Demographic Characteristics in Patients with Hip Fracture," Open Journal of Orthopedics, Vol. 3 No. 4, 2013, pp. 193-198. doi: 10.4236/ojo.2013.34035.

References

[1] A. Hommel, “Improved Safety and Quality of Care for Patients with a Hip Fracture,” Ph.D. Dissertation, Lunds Universitet, Institutionen for Halsa, Vard Och Samhalle, 2007.
[2] WHO, “Sweden: “Nutrition for Older Persons,” 2011. www.who.int/nutrition/topics/ageing/en/index2.html
[3] V. Novack, A. Jotkowitz, O. Etzion and A. Porath, “Does Delay in Surgery after Hip Fracture Lead to Worse Outcomes? A Multicenter Survey,” International Journal for Quality in Health Care, Vol. 19, No. 3, 2007, pp. 170-176. doi:10.1093/intqhc/mzm003
[4] J.-E. Gjertsen, L.-B. Engesater, O. Furnes, L.-I. Havelin, K. Steindal, T. Vinje and J.-M. Fevang, “The Norwegian Hip Fracture Register Experiences after the First 2 Years and 15,576 Reported Operations,” Acta Orthopaedia, Vol. 79, No. 5, 2008, pp. 583-583. doi:10.1080/17453670810016588
[5] National Board of Health and Welfare, “Sweden: Fallskador i Varden,” 2011. http://www.socialstyrelsen.se/patientsakerhet/riskomraden/fallskador
[6] RIKSHOFT, “Sweden: Hoftfrakturer; 2009a,” 2009. http://www.rikshoft.se/se/index.php?option=com_content&view=article&id=50&Itemid=37
[7] J. Richmond, G.-B. Aharonoff, J.-D. Zuckerman and K.-J. Koval, “Mortality Risk after Hip Fracture,” Journal of Orthopaedic Trauma, Vol. 17, No. 1, 2003, pp. 53-56. doi:10.1097/00005131-200301000-00008
[8] P. Vestergaard, L. Rejnmark and L. Mosekilde, “Increased Mortality in Patients with a Hip Fracture-Effect of Pre-Morbid Conditions and Post-Fracture Complications,” Osteoporosi International, Vol. 18, No. 12, 2007, pp. 1583-1593. doi:10.1007/s00198-007-0403-3
[9] A. Hommel, K. Ulander, K. B. Bjorkelund, P.-O. Norman, H. Wingstrand and K.-G. Thorngren, “Influence of Optimised Treatment of People with Hipfracture on Time to Operation, Length of Hospital Stay, Reoperations and Mortality within 1 Year,” International Journal of the Care of the Injured, Vol. 39, No. 10, 2008, pp. 1164-1174. doi:10.1016/j.injury.2008.01.048
[10] S.-K. Khan, S. Kalra, M. M. Thiruvengada and M. J. Parker, “Timing to Surgery for Hip Fractures: A Systematic Rewiew of 52 Published Studies Involving 291,413 Patients,” International Journal of the Care of the Injured, Vol. 40, No. 7, 2009, pp. 692-697. doi:10.1016/j.injury.2009.01.010
[11] N. Simunovic, P. J. Devereaux and M. Bhandari, “Surgery for Hip Fractures: Does Surgical Delay Affect Outcomes?” Indian Journal Orthopaedia, Vol. 45, No. 1, 2011, pp. 27-32. doi:10.4103/0019-5413.73660
[12] K. B. Bjorkelund, “Acute Confusional State in Elderly Patients with Hip Fracture. Identification of Risk factors and Intervention Using a Prehospital and Perioperative Management Program,” Ph.D. Dissertation, Lunds Universitet, Institutionen for Halsa, Vard Och Samhalle, 2008.
[13] RIKSHOFT, “Sweden: Om Rikshoft; 2009b,” 2011. http://www.rikshoft.se/se/index.php?option=com_content&view=article&id=46&Itemid=27
[14] A. Bottle and P. Aylin, “Mortality Associates with Delay in Operation after Hip Fracture: Observational Study,” British Medical Journal, Vol. 332, No. 7547, 2006, pp. 947-951. doi:10.1136/bmj.38790.468519.55
[15] J. Librero, S. Peiró, E. Leutscher, J. Merlo, E. BernalDelgado, M. Ridao, N. Martínez-Lizaga and G. Sanfélix-Gimeno, “Timing of Surgery for Hip Fracture and In-Hospital Mortality: A Retrospective Population-Based Cohort Study in the Spanish National Health System,” BMC Health Services Research, Vol. 12, No. 15, 2012. doi:10.1186/1472-6963-12-15
[16] C. R. Hamish, I. A. Harris, L. Mcevoy and T. Todovora, “Delay to Surgery and Mortality after Hip Fracture,” The Australian and New Zealand Journal of Surgery, Vol. 77, No. 10, 2007, pp. 889-891. doi:10.1111/j.1445-2197.2007.04267.x
[17] RIKSHOFT-SAHFE, “Annual Report 2009,” 2012. http://rikshoft.se/se/images/stories/arsrapporter/arsrapport2009.pdf
[18] K. B. Bjorkelund, A. Hommel, K.-G. Thorgren, L. Gustafson, S. Larsson and D. Lundberg, “Reducing Delirium in Elderly Patients with Hip Fracture: A Multi-Factorial Intervention Study,” Acta Anaesthesiologica Scandinavia, Vol. 54, No. 6, 2010, pp. 678-688. doi:10.1111/j.1399-6576.2010.02232.x
[19] National Board of Health and Welfare, “Guidelines for Care and Treatment in Patients with Hip Fracture,” Socialstyrelsen, Stockholm, 2003.
[20] RIKSHOFT-SAHFE, “Annual Report 2005,” 2011. http://rikshoft.se/se/images/stories/arsrapporter/Arsrapport2005.pdf
[21] RIKSHOFT-SAHFE, “Annual Report 2006,” 2011. http://rikshoft.se/se/images/stories/arsrapporter/Arsrapport2006.pdf
[22] RIKSHOFT-SAHFE, “Annual Report 2007,” 2011. http://rikshoft.se/se/images/stories/arsrapporter/Arsrapport2007.pdf
[23] RIKSHOFT-SAHFE, “Annual Report 2008,” 2011. http://www.rikshoft.se/se/images/stories/arsrapporter/Arsrapport2008.pdf
[24] RIKSHOFT-SAHFE, “Annual Report 2010,” 2012. http://rikshoft.se/se/images/stories/arsrapporter/arsrapport2010.pdf
[25] Center for Operational Planning and Analysis, 2011. http://www.skane.se/Upload/Webbplatser/vardgaranti/l%C3%A4gesbilder/Uppf%C3%B6jlning%20T2%202011%20h%C3%B6ftprocessm%C3%A5l%20internetversion%20_3_.pdf
[26] HCQI, “Health Care Quality Indicators Project. Initial Indicators Report,” 2012. http://www.oecd.org/dataoecd/1/34/36262514.pdf
[27] M. P. Fantini, G. Fabbria, M. Lausb, E. Carrettaa, S. Mimmia, G. Franchino, L. Faveroc and P. Rucci, “Determinants of Surgical Delay for Hip Fracture,” The Surgeon, Vol. 9, No. 3, 2011, pp. 130-134. doi:10.1016/j.surge.2010.11.031

  
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