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We evaluated the cost and consequences of proximal femoral fractures requiring further surgery because of complications. The data were collected prospectively in a standard manner from all patients with a proximal femoral fracture presenting to the trauma unit at the John Radcliffe Hospital over a five-year period. The total cost of treatment for each patient was calculated by separating it into its various components. The risk factors for the complications that arose, the location of their discharge and the mortality rates for these patients were compared to those of a matched control group. There were 2360 proximal femoral fractures in 2257 patients, of which 144 (6.1%) required further surgery. The mean cost of treatment in patients with complications was £18,709 (£2606.30 to £60,827.10), compared with £8610 (£918.54 to £45,601.30) for uncomplicated cases (p < 0.01), with a mean length of stay of 62.8 (44.5 to 79.3) and 32.7 (23.8 to 35.0) days, respectively. The probability of mortality after one month in these cases was significantly higher than in the control group, with a mean survival of 209 days, compared with 496 days for the controls. Patients with complications were statistically less likely to return to their own home (p < 0.01). Greater awareness and understanding are required to minimise the complications of proximal femoral fractures and consequently their cost.

Original publication

DOI

10.1302/0301-620x.92b12.25021

Type

Journal article

Journal

The Journal of bone and joint surgery. British volume

Publication Date

12/2010

Volume

92

Pages

1669 - 1677

Addresses

Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. chrish49@hotmail.com

Keywords

Humans, Surgical Wound Infection, Hip Fractures, Postoperative Complications, Length of Stay, Fracture Fixation, Reoperation, Epidemiologic Methods, Aged, Aged, 80 and over, Middle Aged, Hospital Costs, Health Services Research, State Medicine, England, Female, Male