ArticleAnnals of the Royal College of Surgeons of England2016
The provision of total hip replacement for displaced intracapsular hip fractures.
Article in Annals of the Royal College of Surgeons of England, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 6 citations in OpenAlex.
- Comparison of acute outcomes from elective total hip replacements and after fragility femoral neck fractures in nonagenarians.BMC musculoskeletal disorders · 2024Article
- Neck of femur fracture: who gets a total hip replacement? A review of 230 eligible patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Variations in Treatment Delivery for Patients with Neovascular AMD in the UK: Results from an Ophthalmology Trainee Clinical Research Network Study.Ophthalmology and therapy · 2017Article
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1 author.
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Abstract
introductionThe National Institute for Health and Care Excellence (NICE) currently recommends the use of total hip replacement (THR) for displaced intracapsular hip fractures in patients who meet certain mobility, cognitive and health criteria.
methodsA multicentre prospective audit was conducted within a defined geographic region to assess current practice and variation in provision of THR for displaced intracapsular hip fractures.
resultsA total of 879 patients with hip fractures, admitted to 8 acute trauma units, were included in this study. Of 462 patients with displaced intracapsular hip fractures, 169 fulfilled the NICE criteria for THR. THR was performed for only 49 of (29%) the eligible patients. There was significant variation in THR provision between the eight units (0% to 50% THR usage, p<0.001). There were statistically significant differences in age, ASA (American Society of Anesthesiologists) grade, abbreviated mental test score and walking ability prior to the injury between patients who underwent fixation, THR or hemiarthroplasty (all p≤0.05). There was a significantly increased chance of not undergoing THR if a patient was older than 77 years (median age for the THR eligible cohort; relative risk [RR]: 7.9, 95% confidence interval [CI]: 2.8-22.0, p<0.001). There was also a trend for this with patients who were ASA grade 3 compared with ASA grade 1 or 2 (RR: 2.7, 95% CI: 1.0-7.3, p=0.06). The surgeons gave multifactorial reasons for not performing THR in eligible patients.
conclusionsThere is significant variation in the provision of THR for eligible hip fracture patients, which is influenced by both patient demographics and the unit to which a patient is admitted.
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