The effect of hospital setting and teaching status on outcomes after hip fracture

This study used the National Inpatient Sample database for 1998 through 2003 to identify patients who were aged 65 years or older and had undergone surgical treatment for an isolated femoral neck or intertrochanteric hip fracture. Hospital setting (urban vs rural) and teaching status (teaching vs nonteaching) were the primary independent variables studied. The final cohort consisted of 226,239 patients. Overall in-hospital mortality was 2.6%. Higher in-hospital mortality risk was associated with increased number of in-hospital complications, increased number of comorbidities, male sex, longer surgical delay, and age 85 years or older. The overall surgical complication rate was 10.1%; there was little effect for any of the studied factors on risk for in-hospital complication. Contrary to expectation, hospital setting and teaching status were generally not as relevant to in-hospital outcomes as other factors were.