Presented in part at the Euroanaesthesia Meeting, Milan, June 2009.
Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network*
Article first published online: 18 DEC 2009
© 2010 The Authors. Journal compilation © 2010 The Association of Anaesthetists of Great Britain and Ireland
Volume 65, Issue 3, pages 243–248, March 2010
How to Cite
White, S. M., Griffiths, R., Holloway, J. and Shannon, A. (2010), Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network. Anaesthesia, 65: 243–248. doi: 10.1111/j.1365-2044.2009.06208.x
- Issue published online: 5 FEB 2010
- Article first published online: 18 DEC 2009
- Accepted: 11 November 2009
The aim of this audit was to investigate process, personnel and anaesthetic factors in relation to mortality among patients with proximal femoral fractures. A questionnaire was used to record standardised data about 1195 patients with proximal femoral fracture admitted to 22 hospitals contributing to the Hip Fracture Anaesthesia Network over a 2-month winter period. Patients were demographically similar between hospitals (mean age 81 years, 73% female, median ASA grade 3). However, there was wide variation in time from admission to operation (24–108 h) and 30-day postoperative mortality (2–25%). Fifty percent of hospitals had a mean admission to operation time < 48 h. Forty-two percent of operations were delayed: 51% for organisational; 44% for medical; and 4% for ‘anaesthetic’ reasons. Regional anaesthesia was administered to 49% of patients (by hospital, range = 0–82%), 51% received general anaesthesia and 19% of patients received peripheral nerve blockade. Consultants administered 61% of anaesthetics (17–100%). Wide national variations in current management of patients sustaining proximal femoral fracture reflect a lack of research evidence on which to base best practice guidance. Collaborative audits such as this provide a robust method of collecting such evidence.