Representation to the accident and emergency department within 1-year of a fractured neck of femur

Journal of Orthopaedic Surgery and Research

Chika E Uzoigwe²  Hardik Bhansali¹  Murtuza Faizi²  Rory G Middleton²  Scott Knapp²  David J Bryson² 

[1] Department of Trauma and Orthopaedics, Kettering General Hospital, Rothwell Road, Kettering, Northamptonshire NN16 8UZ, UK;Department of Trauma and Orthopaedics, Leicester Royal Infirmary, Infirmary Road, Leicester LE1 5WW, UK

关键词: fragility fracture;    falls;    mortality;    morbidity;    Fractured neck of femur;   

Others  :  823313
DOI  :  10.1186/1749-799X-6-63

 received in 2011-06-20, accepted in 2011-12-21,  发布年份 2011

【 摘 要 】

Background

The fractured neck of femur (NOF) is a leading cause of morbidity and mortality. The mortality attendant upon such fractures is 10% at 1 month and 30% at one year with a cost to the NHS of £1.4 billion annually. This retrospective study sought to examine rates and prevailing trends in representation to A&E in the year following a NOF fracture in an attempt to identify the leading causes behind the morbidity and mortality associated with this fracture.

Methods

1108 patients who suffered a fractured NOF between 1 January 2002 and 31 December 2007 were identified from a University Hospital A&E database. This database was then used to identify those patients who represented within 1-year following the initial fracture. The presenting complaint, provisional diagnosis and the outcome of this presentation were identified at this time.

Results

234 patients (21%) returned to A&E on 368 occasions in the year following a hip fracture. 77% (284/368) of these presentations necessitated admission. Falls, infection and fracture were the leading causes of representation. Falls accounted for 20% (57/284) of admissions; 20.7% of patients were admitted because of a fracture, while 56.6% of admissions were for medical ailments of which infection was the chief precipitant (28% (45/161)).

Discussion

The causes for representation are varied and multifactorial. The results of this study suggest that some of those events or ailments necessitating readmission may be obviated and potentially reduced by interventions that can be instituted during the primary admission and continued following discharge.

【 授权许可】

   
2011 Bryson et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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