Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network

Anaesthesia. 2010 Mar;65(3):243-8. doi: 10.1111/j.1365-2044.2009.06208.x. Epub 2009 Dec 18.


The aim of this audit was to investigate process, personnel and anaesthetic factors in relation to mortality among patients with proximal femoral fractures. A questionnaire was used to record standardised data about 1195 patients with proximal femoral fracture admitted to 22 hospitals contributing to the Hip Fracture Anaesthesia Network over a 2-month winter period. Patients were demographically similar between hospitals (mean age 81 years, 73% female, median ASA grade 3). However, there was wide variation in time from admission to operation (24-108 h) and 30-day postoperative mortality (2-25%). Fifty percent of hospitals had a mean admission to operation time < 48 h. Forty-two percent of operations were delayed: 51% for organisational; 44% for medical; and 4% for 'anaesthetic' reasons. Regional anaesthesia was administered to 49% of patients (by hospital, range = 0-82%), 51% received general anaesthesia and 19% of patients received peripheral nerve blockade. Consultants administered 61% of anaesthetics (17-100%). Wide national variations in current management of patients sustaining proximal femoral fracture reflect a lack of research evidence on which to base best practice guidance. Collaborative audits such as this provide a robust method of collecting such evidence.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia / methods*
  • Anesthesia / statistics & numerical data
  • Anesthesia, Conduction / statistics & numerical data
  • Anesthesia, General / statistics & numerical data
  • Clinical Competence
  • Female
  • Hip Fractures / mortality
  • Hip Fractures / surgery*
  • Humans
  • Male
  • Medical Audit
  • Nerve Block / statistics & numerical data
  • State Medicine / statistics & numerical data
  • Time Factors
  • United Kingdom / epidemiology