Length of hospital stay following hip fracture and risk of 30 and 90 day mortality in a United Kingdom cohort.

A recent study identified a length of stay (LOS) of 10 days or less following hip fracture is associated with increased risk of 30-day mortality. This effect has not been previously studied for 90-day mortality or in the United Kingdom (UK). Our aim was to investigate the effect of LOS on 30-day and 90-day mortality following hip fracture in a UK population. In this single-centre study, we retrospectively identified consecutive patients with a hip fracture from the National Hip Fracture Database over 3 years. We excluded patients who died as inpatient during their index admission. The main end-points were 30-day and 90-day mortalities and risk factors for these were examined using stepwise univariate and multivariate Cox regression analyses. Of 1228 patients, mortality at 30-days was 1.2% (15 patients) and 7.8% (96 patients) at 90-days. Mean LOS was 24 days and a total of 206 patients had a LOS of 10 days or less. Following cariate analysis, the highest risk factor for 30-day mortality was a LOS of 10 days or less with a hazard ratio of 7.26 (95% confidence interval 2.56-20.51). Other risk factors for 30-day mortality included increasing age, male gender and chest infection. A LOS of 10 days or less was not associated with increased mortality at 90-days. A short LOS was associated with higher risk of early mortality. We recommend that hip fracture patients be fully rehabilitated prior to discharge to reduce the risk of early mortality.

Templating Hip Arthroplasty.

BACKGROUND: Different methods have been developed and employed with variable degrees of success in pre-operative templating for total hip arthroplasty. Preoperative templating, especially digital templating, has been claimed to have increased the effectiveness of total hip arthroplasty by improving the precision of prediction of prosthetic implant size. AIMS: The overall aim of this systematic review is to identify whether the use of pre-operative templating in total hip arthroplasty procedures has resulted in increased accuracy, reliability and precision of the procedure. Various methods of templating, like traditional acetate overlay and digital method of templating that includes a single radiographic marker and double radiographic marker methods, have been compared to establish the most reliable method of templating. METHODS: We searched the PubMed, Google Scholar Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (1966 to present), EMBASE (1980 to present), CINAHL (1982 to present), Psych INFO (1967 to present) and Clinical Trials Gov. CONCLUSION: The results of this systemic review suggest that preoperative templating is resulting in an enormous increase in the accuracy of total hip arthroplasty and among various methods, King Mark is the most reliable method.