Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study
Harris, Mitchel B
Perry, Daniel C
Costa, Matthew L
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CitationMetcalfe, David, Ali Salim, Olubode Olufajo, Belinda Gabbe, Cheryl Zogg, Mitchel B Harris, Daniel C Perry, and Matthew L Costa. 2016. “Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study.” BMJ Open 6 (4): e010743. doi:10.1136/bmjopen-2015-010743. http://dx.doi.org/10.1136/bmjopen-2015-010743.
AbstractObjective: To explore whether older adults with isolated hip fractures benefit from treatment in high-volume hospitals. Design: Population-based observational study. Setting: All acute hospitals in California, USA. Participants: All individuals aged ≥65 that underwent an operation for an isolated hip fracture in California between 2007 and 2011. Patients transferred between hospitals were excluded. Primary and secondary outcomes Quality indicators (time to surgery) and patient outcomes (length of stay, in-hospital mortality, unplanned 30-day readmission, and selected complications). Results: 91 401 individuals satisfied the inclusion criteria. Time to operation and length of stay were significantly prolonged in low-volume hospitals, by 1.96 (95% CI 1.20 to 2.73) and 0.70 (0.38 to 1.03) days, respectively. However, there were no differences in clinical outcomes, including in-hospital mortality, 30-day re-admission, and rates of pneumonia, pressure ulcers, and venous thromboembolism. Conclusions: These data suggest that there is no patient safety imperative to limit hip fracture care to high-volume hospitals.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:26860017
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