ArticleGeriatric orthopaedic surgery & rehabilitation2018
Is There a Role for Early Palliative Intervention in Frail Older Patients With a Neck of Femur Fracture?
Article in Geriatric orthopaedic surgery & rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The 2023 WSES guidelines on the management of trauma in elderly and frail patients.World journal of emergency surgery : WJES · 2024Guideline
- Review
- Experience with hip denervation in non-operative hip fracture care for frail older patients in the Netherlands: an interview study.BMJ open · 2025Article
- SPING Block Analgesia in Non-Operative Management of Proximal Femur Fractures in Older Adults Living with Frailty: A Retrospective Cohort Study.Geriatrics (Basel, Switzerland) · 2025Article
- Strategies to improve end-of-life decision-making and palliative care following hip fracture in frail older adults: a scoping review.Age and ageing · 2024Article
- Attitudes to Palliative Care in Patients With Neck-of-Femur Fracture-A Multicenter Survey.Geriatric orthopaedic surgery & rehabilitation · 2020Article
- Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with a neck of femur fracture have a high mortality rate. National outcomes have improved significantly as the management of this patient group is prioritized. In 2016, however, 4398 (6.7%) patients died within 30 days of admission.
objectiveTo investigate whether palliative care could be integrated early in the care plan for high-risk patients.
methodsAll cases of inpatient mortality following neck of femur fracture at North Bristol Major Trauma Centre over a 24-month period were reviewed. A comprehensive assessment of care was performed from the emergency department until death. All investigations, interventions, and management decisions were recorded. A consensus decision regarding expected mortality was made for each case at a multidisciplinary meeting which included surgical, orthogeriatric, nursing, and anesthetic team input.
resultsA total of 1033 patients were admitted following a neck of femur fracture. There were 74 inpatient deaths, and 82% were considered predictable at our multidisciplinary meeting. The mean length of stay was 18 days (range: 0-85, median 14). In 42% of cases, mortality was considered predictable on admission, and 40% were considered predictable following acute deterioration. These patients received on average 28 blood tests (range: 4-114) and 6.8 X-rays and computed tomographies (range: 2-20). Of this, 66% received end-of-life care; mean duration 2.3 days (range: 0-17).
conclusionsMortality rates remain high in a
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