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Proximal femur fractures especially problematic, costly for elderly patients
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NICE — Proximal femur fractures are a major cause of morbidity in the elderly and comprise a significant proportion of acute orthopedic admissions in Europe, according to a report presented here.
Researchers from Ireland studied the demographics of and factors responsible for prolonged hospital stay following admission with a fractured femoral neck. They presented their findings at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress, here.
Ian Gargan and Kevin Mulhall from Dublin reviewed a consecutive series of hip fractures presenting to their unit over a 5-year period between 2000 and 2004. They collected information on the patients from the national casualty register and from a hospital inpatient enquiry database.
Pathological, high-energy and periprosthetic fractures were excluded.
“We reviewed records to obtain demographic and clinical data, including age, sex, length of stay, time to operation and comorbidities,” Gargan said. “Those who remained inpatients for greater than 14 days were analyzed for the reasons responsible for their prolonged stay.”
The researchers treated 717 low-energy hip fractures from 2000-2004. The average age for males and females was 73.6 years and 79.6 years, respectively.
The overall average length of stay was 28 days, and 351 patients (49%) stayed in the hospital longer than 14 days. For these patients, the mean length of stay was 48 days.
The primary reasons for prolonged stay included acute medical and surgical issues (32%), social and placement issues (22%), active chronic disease (17%) and postoperative complications (4%).
“What we are seeing is that hip fractures continue to pose challenges for the patients as well as for the acute trauma services that must care for these individuals,” he said. “It constitutes a significant burden on our health care systems.”
Additional treatment strategies are needed to address the medical and social reasons for prolonged stay in and delayed discharge from hospitals, he added.
For more information:
- Gargan I, Mulhall K. Causes of prolonged stay following low-energy fracture of the proximal femur: issues of most concern. Paper F220. Presented at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress. May 29-June 1, 2008. Nice.