BMJ  2006;332:1093 (6 May), doi:10.1136/bmj.332.7549.1093

Letter

Mortality associated with delay in operation after hip fracture

Scottish data provide additional information...

The first 150 words of the full text of this article appear below.

EDITOR—Bottle and Aylin's study provides evidence of an association between delay to hip fracture surgery and mortality,¹ a topic that has proved controversial.² However, as their analysis depended on routinely collected data, the study had important limitations. Scottish data provide additional relevant information.

Scottish hip fracture audit data are collected prospectively,³ and records have been linked to routinely collected data for hospital admissions and mortality.⁴ We studied one year mortality in patients undergoing hip fracture surgery between 1998 and 2003, in groups of patients stratified by the reason for delay to surgery (n = 8470). We used Cox proportional hazards regression analysis to adjust for potential confounding factors including age, sex, hospital, and residence before the fracture; American Society of Anesthesiologists' grade (a measure of systemic illness before fracture); and number and type of hospital admissions in the five years before the hip fracture.

Surgery was delayed by . . . [Full text of this article]

Public Health Department, NHS Fife, Cameron House, Cameron Bridge, Windygates, Leven KY8 5RG gm@nhs.net

School of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh EH8 9AG

Information Services, NHS National Services Scotland, Edinburgh EH12 9EB

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