Does the place of fall influence the time to specialist treatment in patients sustaining hip fractures ? A study of 4917 patients falling in four different settings

Published online: Apr 27 2011

Sameer K. Khan, Anil Khanna, Moaz Al-Salahi, Martyn J. Parker

From Peterborough District Hospital, Peterborough, U.K.


Delay to treatment is a multifactorial issue for patients sustaining hip fractures. The place of fall could possibly impact on the time to specialist care. We aimed to investigate the correlation between the place where a hip fracture occurs, and the time to initiation of specialist fracture-specific treatment. We retrospectively analysed data that had been collected on 4917 consecutive hip fracture admissions to our unit. The recorded places of fall were divided into four groups, including those falling ‘outside home', ‘at home', ‘residential or nursing home', and ‘hospital inpatients' respectively. A 24-hour scale was used to record times of fall and of initiation of treatment. The latter was the time of admission to Accident & Emergency for groups 1-3, and the time of referral to the Orthopaedic team for group 4. 23.5% patients fell outside their own home (group 1), and presented at only 2 hours post-injury. Patients in both group 2 (47.7%) and group 3 (23.6%) presented after 3 hours. Group 4 (4.9%) patients had to wait a median of 8 hours being referred to the Orthopaedic team. We found an interesting correlation between the place of injury and the delay in receiving treatment, in that those patients already receiving maximal healthcare attention, had to wait the longest to be referred to specialist care.