Key result
Avoidable operative delay affects up to ~55% of hip fractures, driven by limited theatre capacity.
Why the study?
Patients with proximal femur fractures experience delays in surgery, and the reasons for these delays need to be examined to improve compliance with guidelines recommending surgery within 24 hours.
What are the reasons for operative delay in patients with proximal femur fractures?
Observational (n=235)
Yes
What are the reasons for operative delay in patients with proximal femur fractures?
Lack of operating theatre capacity is the primary reason for avoidable delays in hip fracture surgery, hindering compliance with 24-hour surgical guidelines.
Theatre capacity is the leading cause of avoidable delays in hip fracture surgery; hypothesis-generating for interventions to improve access and outcomes.
We undertook a simultaneous prospective two-centre study to examine why patients with fractures of the proximal femur experience a delay in undergoing surgery. At centre 1, 23 of 105 patients (22%) suffered an avoidable delay, 18 (78%) because of a lack of theatre capacity while at centre 2, 71 of 130 patients (55%) had an avoidable delay, with 54 (76%) because of this cause. Miscellaneous reasons such as poor ward management, co-existing medical conditions, and lack of equipment were responsible for the remainder of the delays. Without a substantial increase in operating capacity for acute trauma, it will not be possible to comply with guidelines which recommend surgical treatment within 24 hours in elderly and vulnerable patients.
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Meibom et al. (2007) conducted an observational in fractures of the proximal femur (n=235). Operative delay was evaluated on avoidable delay. Avoidable operative delay occurred in 22% and 55% of patients with proximal femur fractures at two centers, primarily due to a lack of theatre capacity.
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