Fewer patients with hip fractures admitted to theatre within target time last year

Report finds overall improvement in treatment of hip-fracture patients over the past five years

Overall, hip-fracture patients are being admitted and receiving surgery faster. They are more likely to receive specialist assessment, according to the latest report of the Irish Hip Fracture Database. Photograph: Bryan O'Brien
Overall, hip-fracture patients are being admitted and receiving surgery faster. They are more likely to receive specialist assessment, according to the latest report of the Irish Hip Fracture Database. Photograph: Bryan O'Brien

The proportion of hip-fracture patients who received timely admission to hospital fell last year for the first time since auditing of this metric began.

Overall, hip-fracture patients are being admitted and receiving surgery faster, and are more likely to receive specialist assessment, according to the latest report of the Irish Hip Fracture Database.

The percentage of patients admitted to an orthopaedic ward or admitted to theatre from the emergency department, within four hours, has increased from 11 per cent in 2017 to 26 per cent in 2021. However, last year’s figure is down from the 33 per cent recorded in 2020.

The proportion of patients receiving surgery within 48 hours increased from 69 per cent in 2017 to 76 per cent in 2021.

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Three per cent of patients developed a pressure ulcer or injury throughout the period from 2017 to 2021.

Bone health assessment

Some 83 per cent of patients were seen by a geriatrician last year, up from 50 per cent in 2017.

The proportion of patients receiving a bone health assessment increased from 73 per cent to 92 per cent, while those receiving a specialist falls assessment rose from 47 per cent to 85 per cent.

There was also an increase in the percentage of patients mobilised on the day of surgery, or the day after, from 73 per cent to 82 per cent. Thirty per cent of patients were discharged directly home from the acute hospital in 2021, compared with 22 per cent in 2017.

Services for hip-fracture patients have been revamped over the past five years through the appointment of advanced nurse practitioners, a bypass for patients with suspected fractures to hospitals with an orthopaedic service and shorter hospital stays.

Since 2018, over €2 million in best-practice tariff payments have been made to hospitals which meet targets on treatment of hip fractures.

Hip fracture describes a break or fracture in the upper portion of the thigh bone (femur) where the bone meets the pelvis. Most occur as a result of a fall from standing height or less, commonly in the home. As the report notes, people are spending more time in the home than ever as a result of the Covid pandemic, and should therefore be more vigilant than ever about keeping safe.

To improve home safety, run through the following checks:

  • Make the entrance safe by remedying uneven or slippery footpaths and removing trip hazards
  • In the home, remove clutter to make rooms and walkways safe
  • Remove rugs or use double-sided tape to make them safe
  • Ensure adequate lighting
  • Make stairs and steps/kitchen/bathroom/bedrooms safe
  • Put a bell on the collar of a pet to ensure their whereabouts are known.
Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.