New approach to hip fractures reduces op waiting times and mortality rates

  A multidisciplinary approach to hip fractures that reduces delay in operations improves outcome, says a team from Nottingham University Hospitals.

About 10% of people who fracture their hip (proximal femoral fracture) die within 30 days.

By carefully coordinating a team of orthopaedic medical experts, physiotherapists, occupational therapists, nurses, nursing assistants, discharge coordinators and osteoporosis nurse specialists , 70% of patients had surgery within 40 hours compared to 55% and the rate of mortality dropped (from 9.23% to 8.44%).

A member of the team from Nottingham University Hospitals attends all morning trauma meetings, and reviews all elderly patients with hip fractures before surgery. Urgent medical issues are a priority and patients assessed after the operation by the orthogeriatric team who assist in general management, management of medical complications, falls prevention, bone health, dementia screening and discharge planning.

“Delaying theatre has been shown to increase complications, particularly chest infections and pressure sores in this group of patients,” explains study author, Mark Gaden. “The pre-operative input from the orthogeriatric team is very much directed towards rapid and effective optimisation of the patient’s medical condition with a view to early operative intervention.”