TY  - JOUR
PY  - 2022//
TI  - Hip fracture management in the emergency department and its impact on hospital outcomes: a retrospective cross-sectional analysis
JO  - European geriatric medicine
A1  - Thiam, Chiann Ni
A1  - Khor, Hui Min
A1  - Pang, Gordon Hwa Mang
A1  - Lim, Wan Chieh
A1  - Shanmugam, Tharshne
A1  - Chandrasekaran, C. Sankara Kumar
A1  - Singh, Simmrat
A1  - Zakaria, Mohd Idzwan Bin
A1  - Ong, Terence
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - PURPOSE: The emergency department (ED) plays an important role in initiating early treatment for hip fractures and ensuring prompt transfer to orthopaedic wards. This study reported on the care delivered in a tertiary centre ED in Malaysia and the association between time spent in ED with hospital outcomes. <br><br>METHODS: Patients aged ≥ 65 years with fragility hip fractures and seen by the geriatric team were recruited. Data were collected on patient characteristics, key time points for treatment and hospital outcomes. Median time in ED was used to dichotomise long and short waiting time. <br><br>RESULTS: 447 patients were recruited. The mean (SD) age was 80.5 (7.0) years and 69.8% were women. 74.9% were prescribed analgesia within 30 min. Median (Q1,Q3) time to diagnostic imaging was 27.0 (24.0-43.0) minutes, clinician confirmation of fracture was 83.0 (49.0-129.0) minutes, and time in ED was 4.8 (3.5-6.9) h. A weekday, weekend, in-hour or out-of-hour admission did not demonstrate a difference in the time important care was delivered. Patients who spent ≥ 5 h in ED had more cardiac events (4.6 vs 10.1%, p = 0.023) and more spent ≥ 14 days in hospital (17.5 vs 29.0%, p = 0.004) compared to those < 5 h. No significant increase in inpatient complications (43.5 vs 34.6%, p = 0.054), length of stay (median, 8 vs 7 days, p = 0.119), care home discharge (5.3 vs 4.6%, p = 0.772), or in-hospital death (6.3 vs 4.2%, p = 0.313) were observed. <br><br>CONCLUSION: Time to early hip fracture pain relief and diagnosis was adequate in this ED. Time ≥ 5 h in ED was associated with cardiac events and 2 weeks or more inpatient stay.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-7649
UR  - http://dx.doi.org/10.1007/s41999-022-00654-0
ID  - ref1
ER  -