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Determinants of time to surgery for patients with hip fracture
Author(s) -
Zeltzer Justin,
Mitchell Rebecca J.,
Toson Barbara,
Harris Ian A.,
Close Jacqueline
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12671
Subject(s) - medicine , hip fracture , confidence interval , intervention (counseling) , surgery , logistic regression , presentation (obstetrics) , emergency medicine , general surgery , osteoporosis , nursing
Background Guidelines for hip fracture care suggest that patients with hip fracture should undergo surgery on the day of or day after admission to hospital. This study examined factors affecting time to surgery for hip fracture extracted from existing administrative datasets in N ew S outh W ales ( NSW ), A ustralia. Method A retrospective analysis of patients with hip fracture aged 65 years and over undergoing surgical intervention in NSW public hospitals between 1 J uly 2000 and 30 J une 2011. A multinomial logistic model was used to identify factors impacting on time to surgery from 1 J uly 2006 to 30 J une 2011. Results A total of 49 317 hip fracture procedures were recorded during 2000–2001 to 2010–2011. Sixty‐four per cent of patients received operative treatment on the day of or day after admission. Co‐morbidity, type of surgical procedure and day of presentation all impacted significantly on time to surgery. Fourteen per cent required an inter‐hospital transfer prior to receiving operative intervention. Transferred patients were 2.6 (95% confidence interval ( CI ): 2.31–2.85) times more likely to wait 2–4 days and 3.2 times more likely to wait 5 or more days (95% CI : 2.77–3.76) for surgery compared with patients presenting to an operating hospital. Conclusion Significant variation exists between hospitals in the time to surgery that is not solely explained by measures of case mix or geography. Opportunities exist to consider other factors contributing to this variation and to ensure timely access to surgical intervention in the future.