Hip Fracture and the Weekend Effect in an Irish Trauma Hospital

Area of Science:

• Geriatric Medicine
• Trauma Surgery
• Public Health

Background:

• Hip fractures are a significant cause of morbidity and mortality in older adults.
• The 'weekend effect' suggests potential disparities in care and outcomes for patients admitted or treated during weekends.
• National Clinical and Hospital Development (NCHD) changeover periods may also influence patient management and outcomes.

Purpose of the Study:

• To investigate the association between weekend admissions, weekend surgeries, and NCHD changeover month admissions with 1-year mortality (OYM) in hip fracture patients.
• To determine if the timing of hospital admission or surgical intervention impacts survival rates for hip fracture management.
• To provide data on the weekend effect specific to hip fracture care in an Irish hospital setting.

Main Methods:

• Retrospective analysis of hip fracture admissions (> 60 years old) at Tallaght University Hospital (TUH) from 2013-2016.
• Utilized data from the Irish Deaths and Events Registry to track 1-year mortality events.
• Employed logistic regression to assess the relationship between OYM and weekend admission, weekend surgery, and NCHD changeover admissions.

Main Results:

• A total of 646 hip fracture patients were analyzed.
• 27.5% of admissions and 28.4% of surgeries occurred during weekends.
• No statistically significant relationship was found between weekend admissions, weekend surgeries, or NCHD changeover admissions and 1-year mortality.

Conclusions:

• This study is the first to examine the weekend effect on fragility hip fractures and mortality in Irish patients.
• The findings indicate no significant weekend effect on 1-year mortality in this cohort of hip fracture patients.
• Hospital admission or surgical timing during weekends or NCHD changeover months does not appear to influence survival outcomes for hip fracture management at TUH.