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Research

ARE THE STANDARDS SET FROM THE SCOTTISH HIP FRACTURE AUDIT SUBJECT TO THE HAWTHORNE EFFECT?

West of Scotland Research Society (WOSORS) - Glasgow Meeting of Orthopaedic Research (GLAMOR)



Abstract

Collection of new data for the Scottish hip fracture audit stopped in December 2008. The proposed standard of operating on 98% of all hip fractures within 24 hours of admission, subject to medical fitness and during safe operating hours should now be maintained.

Methods

We prospectively collected data from 102 consecutive hip fracture patients documenting the patient's journey from admission to discharge from the orthopaedic ward to look at whether the standard had been maintained.

Results

50% of patients get to theatre 24hrs or earlier with 60% catheterised perioperatively.50% of patients were moved from the acute orthopaedic facility at a week with less than 20% of these getting back to their usual place of residence. 25% were still on the acute ward at two weeks and 3% died in the immediate post operative period. However, the number of co-morbidities did not seem to correlate with time to discharge. The majority of patients transferred to onward care moved to the geriatric rehabilitation ward within the hospital.

Prioritisation of hip fracture patients on the trauma list needs to be continued along with improvements in the availability of rehabilitation beds. Pre-operative medical work up for patients with reversible illness and post-operative geriatric care will improve the outcomes for these frail patients.


Correspondence should be sent to: Mr R. Dolan; email: