Meeting Management Standards and Improvement in Clinical Outcomes Among Patients With Hip Fractures

Objectives: To determine the association between management standards and clinical outcomes among patients with hip fracture (HF). Methods: Data from a prospective cohort study were linked with hospital administration data. Results: In 2014 and 2015, 493 patients had surgery for HF. The proportion of patients meeting care standards ranged from 69% for surgery within 48 hours to 96% for being seen by a geriatrician. Thirty-nine per cent of patients received all the standards. The mean waiting time for surgery was 44 hours (median, 34 hours; interquartile range [IQR], 22-58 hours). The mean length of stay for patients who were alive at discharge was 17 days (median, 13 days; IQR, 6-24 days). Fifty-six patients were readmitted within 28 days of discharge (12%), and 40 patients died within 28 days of admission (8.1%). Patients who received all standards were less likely to be readmitted or die. Surgery within 48 hours and being seen by a physiotherapist were associated with a lower mortality rate. Conclusions: The management standards, collectively and in particular, assessment by a physiotherapist and surgery within 48 hours were significantly associated with better clinical outcomes.