Title : 10-year outcome of a dedicated hip fracture unit embedded within a Level 1 major trauma centre
Abstract:
Introduction
Dedicated hip fracture units (HFUs) within Major Trauma Centres (MTCs) have been shown to reduce variances in length of stay and trends to reduce time to theatre in short-term studies.
This 10-year study aims to assess the sustained impact of a HFU on patient flow and mortality in a MTC setting.
Methods:
A dedicated HFU was established at the student center on 1st July 2015, our study period extended from 5-years prior to 5-years after its formation; “pre-HFU” and “post-HFU” respectively (bed spaces and theatre capacity remained constant).
Pre-HFU fragility hip fractures were managed concurrently to general and major trauma patients, post-HFU hip fractures were managed in a ring-fenced unit with co-located MDT support including operating theatres.
Time-to-theatre (TTT), patient outcomes (length of stay (LoS), 30-day, 120-day and 1-year mortality) were ascertained from a retrospective interrogation of a prospectively collected database, cross referenced against the trust’s NHFD dataset.
Results:
There were 5346 fragility hip fractures, sustained by 4998 patients, during the study period. There were 2533 cases in the pre-HFU period and 2813 in the post-HFU period, with no significant differences in outcome risk factors between the patient cohorts: age, gender, type of fracture, ASA grade and treatment type (p>0.05).
TTT, LoS, 30-day and 1-year mortality all showed significant improvements (p<0.001) post-HFU introduction when compared to the pre-HFU cohort.
Conclusions:
-To our knowledge, this is the largest non-registry study on the clinical efficacy of aHFU. In comparison to previous delivery models, the results demonstrate sustained improvements in the timing of surgical treatment, LoS and mortality rates.
What will the audience learn from my presentation?
The benefits of specialized care units, such as dedicated hip fracture units (HFUs), in improving patient outcomes.
- The importance of multidisciplinary team (MDT) collaboration in managing fragility hip fractures, including access to operating theatres.
- The impact of a HFU on key metrics such as time-to-theatre (TTT), length of stay (LoS), and mortality rates.
- The sustained effectiveness of a HFU over a 10-year period, highlighting the long-term benefits of this care model.
- The potential for implementing similar HFUs in other healthcare settings to improve care for patients with fragility hip fractures.
