Elderly hip fracture patients admitted to the trauma service: does it impact patient outcome?

Hip fractures are primarily a disease of the elderly. Advanced age and associated comorbidities in this patient population can lead to adverse outcomes. We routinely admit our hip fracture patients to the Trauma Service (TS). The goal of this study is to see if this policy has had a positive impact on patient outcome.

The Jacobi Medical Center Trauma and Operating Room registries were used to identify all patients aged 65 and over who presented with a hip fracture during the 5-year period from January 1, 2000 to December 31, 2004. Patient charts were used for data retrieval. Outcome variables were length of hospital stay (LOS), time from admission to surgery, in-hospital complication, and in-hospital mortality rates.

Complete data were available in 255 patients out of a total of 274 admitted in the study period. The mean age was 81.0 years. The median Injury Severity Score was 10 (range, 9-34). Two hundred forty (94.1%) patients were admitted to the TS. The mean time from admission to surgery was 1.9 days and the mean LOS was 10.5 days. In-hospital complication rate and mortality were 35.8% and 2.1%, respectively.

Our policy of admitting elderly hip fracture patients to the TS has resulted in a mortality and LOS among the lowest reported in the literature. This data suggest that there is a clear benefit to admitting elderly hip fractures to the TS.