Long A&E waits for hip breaks can increase odds of death

People who face long waits in A&E after fracturing a hip are at higher risk of death, a study suggests.

Patients who wait more than four hours are also more likely to have a longer stint in hospital, experts found.

Researchers examined data on hip fracture patients aged 50 and over at a trauma centre in Lothian, Scotland, between January 2019 to the end of June 2022.

Delayed disposition from our emergency department was associated with an increased mortality risk and longer length of hospital stay in patients presenting with a hip fracture

Academics found that the odds of still being alive three months after hospital admission were “significantly lower” for patients who were in A&E for more than four hours compared to those who spent less time in the emergency room.

Those who waited more than four hours had a 36% increased odds of dying within 90 days after their hip break compared to those who spent a shorter period in A&E.

The researchers said that the increased risk is the equivalent of “one additional death at 90 days for every 36 patients who waited longer than 4 hours in the emergency department”.

In light of the findings, the Royal Infirmary of Edinburgh has introduced a new “fast track” service so the majority of patients with hip fracture wait for no more than two hours in the emergency room.

Lead author Dr Nicholas Clement, from the Royal Infirmary of Edinburgh and the University of Edinburgh, said: “We’ve developed a fast track care pathway, just in the knowledge of what this study is found and as part of a quality improvement project.

“Our patients – those that don’t have to like another problem like a heart attack or a chest infection and can go straight at the ward – they go to the ward within two hours now.

“The best thing is that they spend as little time in the emergency department as possible and go to the ward, because they need to come in the hospital anyway – they’ve got a hip fracture, it’s not like any decision needs to be made, they need to come straight in the hospital to get the hip fracture fixed.”

Read full story

Source: The Independent, 8 October 2024