Purpose: To evaluate the effects of a policy change from emergency to scheduled management of hip fractures in older patients.
Methods: 91 and 107 patients aged 50 years or older with hip fractures were scheduled for operation on the emergency and orthopaedic lists, respectively. Cancellation rates, consultant supervision rates, after-hour operation rates, 30-day mortality, and preoperative and total length of hospital stay were compared.
Results: When older patients with hip fractures were scheduled on orthopaedic lists rather than emergency lists, the cancellation rates owing to lack of theatre time (4% vs 54%, p<0.001), the supervision rates (45% vs 24%, p=0.002), and after-hour operation rates (1% vs 25%, p<0.001) were significantly better. The 30-day mortality rates decreased from 4.4% to 1.9% (p=0.3). The median preoperative length of hospital stay significantly increased from 2 to 4 days (p=0.046), but the increase in total length of hospital stay was non-significant (6 to 10 days, p=0.14).
Conclusions: Non-emergency management of hip fractures in older patients resulted in fewer cancellations and after-hour operations, and increased consultant supervision. Nonetheless, extra time slots for operating theatres are required to avoid an associated increase in preoperative and total length of hospital stay.