Background: Hip fractures impose a substantial healthcare burden, contributing to increased morbidity, disability, and mortality. The Irish Hip Fracture Standards (IHFS) were officially employed in 2017, providing specialized pathways for hip fracture care to improve patient outcomes. This study evaluated the performance of our unit regarding hip fracture care and analyzed individual outcome parameters.
Methods: Data spanning 5 years (2015 to 2019) preceding the COVID-19 era were extracted from our hip fracture repository. Patients aged 60 years and more were included. The dataset integrated demographic information and outcomes, validating mortality events using the Irish death events registry. Mortality rates were measured cumulatively and at various time intervals. There were 1,685 hip fractures treated during the study timeframe; average patient age was 78 years, with women constituting 68% of the cohort.
Results: The one-year mortality rate was 20.8% (n = 350). Adverse outcomes were observed in older patients, men, and those who had higher American Society of Anesthesiologists scores. Patients adhering to IHFS 1 (P ≤ 0.05) and IHFS 2 (P ≤ 0.05) exhibited improved outcomes. Our institution displayed lower compliance rates with IHFS 1 and 2 when compared to standards 3 to 6, with the latter standards showing no notable impact on mortality outcomes.
Conclusions: While our unit's hip fracture care outcomes align well with national averages, resource constraints hinder full compliance with IHFS 1 and 2, emphasizing the need for targeted resource allocation in areas with the greatest impact on outcomes.
Keywords: Geriatric Orthopaedic Care; Irish Hip Fracture Standards; hip fracture management; mortality outcomes; resource allocation.
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