Elderly Patients With Isolated Hip Fracture Requiring Surgical Intervention: Does Admitting Service Matter?

The American College of Surgeons requires trauma centers to track the number of injured patients admitted to a surgical service as well as nonsurgical admissions (NSAs) as a quality marker. We aim to compare the relationship between admitting service and outcomes in patients with isolated hip fracture (IHF). A 4-year retrospective cohort review of data collected from a single institution's trauma registry for adult patients with IHF was done. Patients were stratified into 2 groups based on admission to a surgical service versus NSA. Demographic and outcome variables including age, gender, Injury Severity Score (ISS), intensive care unit length of stay (ICU-LOS), deep venous thrombosis (DVT), and mortality rates were compared. Analysis of variance and χ test were used for data analysis with statistical significance defined as p < .05. A total of 629 patients with IHF were admitted. Of those, 30 (4.8%) were admitted to a surgical service and 599 (95.2%) were NSAs. Patients admitted to a surgical service were younger but average ISS was similar in both groups. Those admitted to a surgical service had a significantly shorter ICU-LOS than NSA patients (2.97 days vs. 4.91, p < .001). Readmission rate at 30 days (3.3% vs. 1.2%, p > .05) and DVT rates (0% vs. 0.4%, p > .05) were similar between groups. Mortality rates did not differ between groups (3.3% vs. 2.2%, p > .05). Patients with hip fracture requiring surgical intervention admitted to a trauma service have a shorter ICU-LOS than those admitted to nonsurgical services. Other quality markers were similar.