Is there a weekend effect in hip fracture patients presenting to a United Kingdom teaching hospital?

AIM

To compare mortality and time-to-surgery of patients admitted with hip fracture to our teaching hospital on weekdays weekends.

METHODS

Data was prospectively collected and retrospectively analysed for 816 hip fracture patients. Multivariate logistic regression was carried out on 3 binary outcomes (time-to-surgery < 36 h; 30-d mortality; 120-d mortality), using the explanatory variables time-of-admission; age; gender; American Society of Anesthesiologist (ASA) grade; abbreviated mental test score (AMTS); fracture type; accommodation admitted from; walking ability outdoors; accompaniment outdoors and season.

RESULTS

Baseline characteristics were not statistically different between those admitted on weekdays weekends. Weekend admission was not associated with an increased time-to-surgery ( = 0.975), 30-d mortality ( = 0.842) or 120-d mortality ( = 0.425). Gender ( = 0.028), ASA grade ( < 0.001), AMTS ( = 0.041) and accompaniment outdoors ( = 0.033) were significant co-variates for 30-d mortality. Furthermore, age ( < 0.001), gender ( = 0.011), ASA grade ( < 0.001), AMTS ( < 0.001) and accompaniment outdoors ( = 0.033) all significantly influenced mortality at 120 d. ASA ( < 0.001) and season ( = 0.014) had significant effect on the odds of undergoing surgery in under 36 h.

CONCLUSION

Weekend admission was not associated with increased time-to-surgery or mortality in hip fracture patients. Demographic factors affect mortality in accordance with previous published reports.