Dr Foster's Case Notes

Some way to go for consistent implementation of guidance on hip fracture

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7448.1097 (Published 06 May 2004) Cite this as: BMJ 2004;328:1097
  1. Alex Bottle,
  2. Brian Jarman,
  3. Paul Aylin,
  4. Roger Taylor
  1. Dr Foster Unit, Imperial College

    Fractured hips are a common cause of hospitalisation among elderly people, and in the year after treatment the mortality rate may be as much as 30%. For many years medical bodies throughout the world have issued consistent evidence based guidelines for the management of broken hips, but 2002-3 data from the United Kingdom show that implementation of this guidance is patchy. In addition, the data show that the percentage of patients managed conservatively varies considerably between hospitals. These patients have a considerably higher mortality. Further guidance on when to manage conservatively may be appropriate.

    The bottom line

    • In-hospital mortality after admission for fractured neckof femur is 13% in England. For patients aged 65 and over who do not have surgery, mortality is 28%

    • On average, hospitals operate …

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