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SummaryOne thousand, three hundred and thirty three patients who underwent anaesthesia for surgicaljixation of a hip fracture were studied prospectively to assess the effects on outcome of general and spinal anaesthesia. There were no signijcant differences between the groups in risk factors, length of hospital stay or mortality rates after 30 days or one year. The dara presented may be useful for those wishing to audit anaesthetic services provided to patients with hip fracture.

Ten trauma patients and 13 burns patients were studied intensively for the first 36 h and subsequent 6 days post injury in order to investigate the mechanism of trauma and burn associated proteinuria. Burns patient's initial maximum proteinuria occurred between 4 and 8 h post injury, whilst trauma patients showed greatest proteinuria within 4 h. In both groups coexisting myoglobinuria or marked elevation of serum renin activity was not found during the first 36 h. Following admission serum lipid peroxides rose in burns patients reaching a maximum between 2 and 8 h following injury, after which levels fell rapidly; in contrast trauma patient's values were initially within normal limits, but rose sharply after 12 h with peaks occurring between 16 h and 7 days post injury. Some patients within both groups showed a recurrent protein leak 2 to 5 days post injury. The data suggest that myoglobinuria or raised renin levels do not play an important role in trauma associated proteinuria.

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Thirteen trauma patients admitted to a major injuries unit were classified according to their injury severity. Urinary excretion of total protein, albumin and gamma glutamyl transpeptidase (GGT) activity were assessed over the following 6 days. All patients showed an initial glomerular and tubular proteinuria during the first 24 h which subsided by the second post-trauma day. The excretion of total protein and albumin was positively correlated with injury severity. Those patients with the severest injuries showed a marked recurrent total proteinuria around days 3 to 4 post-trauma which exhibited features of a tubular lesion. The recurrent proteinuria peak coincided with peak levels of serum c-reactive protein (CRP).