Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend

Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend

Abstract Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the ‘weekend effect’ at a major...

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Autores principales: Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2017
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Acceso en línea:https://doaj.org/article/3bbc2ee601b046b1a0e5c573f0a15c8d
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spelling oai:doaj.org-article:3bbc2ee601b046b1a0e5c573f0a15c8d2021-12-02T11:53:06ZComparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend10.1038/s41598-017-01308-z2045-2322https://doaj.org/article/3bbc2ee601b046b1a0e5c573f0a15c8d2017-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01308-zhttps://doaj.org/toc/2045-2322Abstract Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the ‘weekend effect’ at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs. 71%) and time to geriatric review (86 vs. 91%). Weekend admission 30-day mortality was marginally lower than weekday (9.7% vs. 10.2%, OR 0.94, 95% CI 0.67 to 1.32, p = 0.7383). Increasing age, female gender, co-morbidities and confusion increased mortality risk. Binary regression analysis including these variables found no significant ‘weekend effect’. Despite the unit observing an increasing workload in the last five years, with meticulous workforce planning, senior doctor provisions and careful use of resources, it is possible to provide a seven-day fracture neck of femur service with no variation in thirty-day mortality by the day of admission.Rajpal NandraJack PullanJonathan BishopKhalid BalochLiam GroverKeith PorterNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-7 (2017)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Rajpal Nandra
Jack Pullan
Jonathan Bishop
Khalid Baloch
Liam Grover
Keith Porter
Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
description Abstract Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the ‘weekend effect’ at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs. 71%) and time to geriatric review (86 vs. 91%). Weekend admission 30-day mortality was marginally lower than weekday (9.7% vs. 10.2%, OR 0.94, 95% CI 0.67 to 1.32, p = 0.7383). Increasing age, female gender, co-morbidities and confusion increased mortality risk. Binary regression analysis including these variables found no significant ‘weekend effect’. Despite the unit observing an increasing workload in the last five years, with meticulous workforce planning, senior doctor provisions and careful use of resources, it is possible to provide a seven-day fracture neck of femur service with no variation in thirty-day mortality by the day of admission.
format article
author Rajpal Nandra
Jack Pullan
Jonathan Bishop
Khalid Baloch
Liam Grover
Keith Porter
author_facet Rajpal Nandra
Jack Pullan
Jonathan Bishop
Khalid Baloch
Liam Grover
Keith Porter
author_sort Rajpal Nandra
title Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
title_short Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
title_full Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
title_fullStr Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
title_full_unstemmed Comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
title_sort comparing mortality risk of patients with acute hip fractures admitted to a major trauma centre on a weekday or weekend
publisher Nature Portfolio
publishDate 2017
url https://doaj.org/article/3bbc2ee601b046b1a0e5c573f0a15c8d
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