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Hip Fracture and the Weekend Effect in an Irish Trauma Hospital

C Downey1, S Flannery1, A Izydorczyk1

  • 1Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin 24

Irish Medical Journal
|September 20, 2019
PubMed

Insights

This study found no significant link between weekend admissions or surgeries and one-year mortality (OYM) for hip fracture patients at Tallaght University Hospital. The timing of care, including National Clinical and Hospital Development (NCHD) changeover months, did not impact patient survival rates.

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.

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