Time to surgery and transfer‐associated mortality for hip fractures in Western Australia

Abstract

This study evaluated hip fracture transfer times, delays to definitive surgery affecting mortality and the negative impact of patient transfer on outcomes.

Impact of pre‐surgery hospital transfer on time to surgery and 30‐day mortality for people with hip fractures

“…In our large study of NSW people with hip fractures, we found that transfer from non‐operating to operating hospitals, after adjusting for patient and hospital characteristics, was not associated with higher 30‐day mortality, despite increasing the time between initial presentation and surgery. This is contrary to the findings of earlier, single centre studies in Australia 4‐6 . However, our study was the first to control for several key person‐level factors that increase the risk of death, and our findings suggest that time to surgery may be less important for health outcomes than these factors when other dimensions of care quality are equal.…”

The Tyranny of Distance: How Hospital Transfer Affects Time to Surgery for Hip Fracture Patients

“…There have been no large-scale or long-term observational studies reviewing time to surgery based on regions within WA. One smaller study looking at a single institution found a 12-hour delay to surgery in patients that required an inter-hospital transfer which was associated with increased mortality [ 10 ].…”

Predictors of interhospital transfer delays in acute surgical patient deaths in Australia: a retrospective study

“…Interhospital transfer is an independent predictor of mortality in surgical patients, 17,18 regardless of time to surgery or number of comorbidities, 19,20 which is associated with increased complications, duration of stay, treatment costs and places greater demand on clinical resources than direct admissions from the emergency department. [21][22][23][24] By extension, any delays in patient transfer lead to further delays with surgery and result in longer inpatient stay.…”