Hip fracture audit: the Nottingham experience

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Public Health

Background:

• The Nottingham Hip Fracture audit, initiated in May 1999, has been instrumental in data collection and analysis for hip fracture patients.
• High-quality data collection is crucial and best achieved by dedicated, trained staff, proving cost-effective through training audit clerks in data analysis.

Purpose of the Study:

• To develop and utilize the Nottingham Hip Fracture score for predicting long-term survival and 30-day mortality in hip fracture patients.
• To assess the influence of pre-operative factors (age, cognitive state, mobility, residential status) on long-term survival in the geriatric population.
• To analyze trends in hip fracture prevalence and mortality rates over time.

Main Methods:

• Development of a pre-operative scoring system (Nottingham Hip Fracture score) for patients over 65 undergoing hip fracture surgery.
• Utilizing audit data to assess 5-year mortality and the impact of pre-operative variables on long-term survival.
• Analysis of hip fracture prevalence and mortality (30-day and 1-year) trends.

Main Results:

• The Nottingham Hip Fracture score effectively predicts 30-day mortality and aids in identifying patients with higher long-term survival chances.
• A decrease in both 30-day and 1-year mortality rates has been observed over time.
• The score has proven highly useful in clinical practice for pre-operative risk stratification.

Conclusions:

• The Nottingham Hip Fracture score is a valuable tool for optimizing surgical management and improving long-term outcomes for hip fracture patients.
• Continuous data collection and analysis are essential for monitoring trends and improving care quality.
• The establishment of the UK National Hip Fracture Database aims to standardize and enhance care quality across the health service.