Relevant surgery within the first two days following emergency admissions to hospital of persons with fractured proximal femur.
The purpose of the indicator is to help monitor National Health Service (NHS) success in prevention and treatment of fractured proximal femur. This is a serious condition causing pain and immobility, requiring hospitalisation. Mortality is high, with approximately one in five patients with the fracture being dead within one year. Some fractures are potentially preventable through interventions aimed either at whole populations (e.g. reducing smoking rates, promoting better nutrition and higher levels of physical activity) or at people at risk of having a fracture. The latter include timely identification of those at risk (e.g. those with osteoporosis, likelihood of having an accident) and management of risk e.g. medication, home safety, mobility aides, padded clothing etc. Observational studies of surgical outcomes associated with fractured proximal femur have suggested that where there is a significant delay from admission to surgery, there is an increased risk of morbidity, complications, and poor rehabilitation. Guidelines from the Royal College of Physicians have specified that operations for fractured proximal femur should normally occur within 24 hours of admission. However, it is acknowledged that delayed surgery may be more a reflection of patients with other medical conditions making them unfit for surgery than of inadequate management. Whatever the reason for delayed surgery, it is a proxy for poorer outcomes. The NHS may be helped to learn lessons from organisations with lower rates of hospitalisation and higher rates of timely surgery following fractured proximal femur.
This indicator has been discontinued and so there will be no further updates.
Legacy unique identifier: P00035