Purpose

The prevention of a subsequent, contralateral hip fracture is targeted as an avoidable event in the elderly. Fall prevention and bone strengthening measures have met with limited success and the urgency of their effect is undetermined. Our objective was to evaluate the time to second hip fracture (the time between a first and a subsequent, contralateral fracture) in elderly patients, using a population-based administrative health data set.

Purpose

The measurement of functional outcomes in pelvic fracture patients remains difficult for authors. We aimed to test the construct validity, respondent burden, and patient perception of three previously published pelvic outcome questionnaires.

Purpose

To determine whether there have been changes in the age, sex and subtype specific first hip fracture rates in Canadian province of British Columbia (BC) between 1990 and 2004.

Purpose: We aimed to determine the effect of delay to surgery in hip fracture patients, including in hospital mortality, major complications, minor complications and length of hospital stay.

Method: We identified 615 eligible patients from the VGH Orthopaedic Trauma database between 1998 and 2002. A thorough chart review was performed. Age, gender, time from admission to surgery, pre-existing medical comorbidity, length of acute care hospital stay, major medical complications, minor medical complications and in hospital death were recorded and categorized. Patients were categorized into three risk groups for pre-existing comorbidity, and three groups for delay to surgery (48 hours). Chi-squared tests were performed to determine the association of delay to surgery to death, major complications, minor complications and length of stay, as a categorical variable. Multivariate logistic regression analysis was used to evaluate these associations, while adjusting for age, gender, and pre-existing medical comorbidity. Anvoa test was used to evaluate the association between length of stay, as a continuous variable, and delay to surgery.

Results There were 471 female patients, and 141 male patients. We identified 52 deaths (8.5%), 72 major complications (11.7%) and 238 minor complications (38.7%). The delay to surgery was < 24 hours in 346 patients (56.3%), 24–48 hours in 216 (35.1%), and > 48 hours in 50 (8.1%). The mean length of hospital stay was 23.4 days. Chi squared test showed no statistically significant association between delay to surgery and in hospital death (p= 0.787), despite a trend to increasing death (< 24 hours 8.1%, 24–48 hours 8.3%, > 48 hours 12.2%). There was no statistically significant association between delay and minor complications. Statistically significant associations between delay to OR and length of hospital stay (p= 0.0026), and the occurrence of a major complication (p=0.0085) were found. Regression analysis of major complications revealed an odds ratio of 1.47 for the > 48 hour group compared to the < 24 hour group, with a confidence interval of 1.15–1.87. Regression analysis did not show a statistically significant odds ratio for either death or minor complications.

Conclusion: There is a trend to increasing mortality and minor complications with a delay to surgery in hip fractures. A statistically significant increase in major medical complications and length of hospital stay with delay to surgery was found in our group. Regression analysis including age, gender and pre-existing medical comorbidity supported the significance of the increased risk of major medical complications with delay, adjusted for age, gender, and pre-existing medical comorbidity.