Hip fractures are a major cause of morbidity and mortality in the elderly and are thought to represent an increasing cohort of our patients. It is estimated that the cost of caring for each patient for their hospital admission is €10,000. There is significant regional and international variation in the incidence rates of such injuries, depending on age, sex and ethnic variations in populations. Recent Irish literature would suggest that the rates in Ireland are exponentially increasing while in the US the rate may be decreasing. The length of stay of such patients is also an important issue especially in the current economic environment. The aim of this study was to define the incidence of hip fractures in the South East. The aim was also to examine any changes to their length of stay that have occurred in a 11 years period.

Independent searches of the operating theatre register and the HIPE (hospital in-patient enquiry scheme) database were undertaken for the time period. Population data was obtained from central census office and the HSE South East offices.

The combined incidence of hip fractures in 2008 and 1998 was 96.06 and 100.90 per 100,000 respectively. The male to female ratio in 2008 was 1:2.67, while in 1998 it was 1:3.04. 13% of the patients in 2008 where under 65 years of age, while in 1998 this figure was 8%. In 1998 the mean length of stay was 17.15. By 2008 this had increased to 23.95 days. The dramatic increase in acute hospital length of stay over the period was estimated to have a burden of more than 14 million euros on health board fund.

This study provides data on a large patient group which is of paramount importance. Health service resources can be allocated appropriately in the future in terms of acute and step-down care based on this data set and results.

Introduction

Increasing numbers of elderly patients are being prescribed Clopidogrel, an anti-platelet agent for medical reasons. There are no international guidelines as to the management of patients with hip fractures on Clopidogrel in peri-operative period especially in relation to timing of the surgery. In Waterford Regional Hospital in Ireland, hip fracture surgery is deferred for 4 days and platelets are reserved for the operative/post-operative period, in case they have significant bleeding or an associated complication. We conducted a retrospective study on patients admitted over a period of 1 year.