News

What association is there between delays to urgent femoral surgery – for non-medical reasons – and patients’ mortality? Researchers at our Biomedical Research Centre’s MSIR (Musculoskeletal, Surgery, Inflammation and Recovery) research theme have been investigating this in a retrospective cohort study, and their paper has been published in The Bone & Joint Journal.

Investigators including orthopaedic surgeons and clinical academics from Nottingham analysed retrospective data concerning over 5,400 patients aged over 60 from the Nottingham Hip Fracture Database.

They reviewed data concerning patients admitted to a major trauma centre with a fragility femoral fracture between April 2016 and March 2023. Researchers measured the time it took to admit patients to theatre, based on their arrival in the emergency department arrival to them being administered with anaesthetic.

Delays beyond 36 hours were categorised as having either medical or logistical reasons. In conclusion, researchers found that surgery, which is delayed beyond 36 hours, for instance due to lack of surgical capacity, can be independently associated with increased mortality following a hip fracture.

“These findings reinforce the need for protected surgical capacity and prioritisation of prompt surgery to improve outcomes in this vulnerable population,” said Mr Chris Busby, lead author of The Bone & Joint Journal paper, who is also an orthopaedic surgeon in training and a member of the NIHR BRC’s MSIR theme.

Over the next decade, according to Mr Busby, hip fractures are expected to double, further increasing the pressure on surgical teams.
The full research paper can be read here