ABSTRACT
OBJECTIVE: To assess the outcomes of elderly hip fracture surgeries performed 12 months before and 12 months after the implementation of a daily 6 am-9 am dedicated orthopaedic trauma room (DOTR) at a Level II community trauma center. DESIGN: Retrospective cohort study. SETTING: Level II academic trauma center. PATIENTS: A total of 431 consecutive trauma patients undergoing surgical management of isolated low-energy hip fractures from January 1, 2018, to December 31, 2019. INTERVENTION: Implementation of a 6 am-9 am DOTR Monday through Friday. MAIN OUTCOME MEASURES: Time to surgery, number of cases performed after hours, surgical time, 90-day morbidity and mortality, and time to therapy. RESULTS: Retrospective analysis showed that despite a 24% increase in surgical hip fracture volume, implementation of a part-time DOTR led to a decrease in after-hours surgery (32.4% vs. 19.6%; P = 0.008) and patients requiring the intensive care unit postoperatively (7% vs. 3.8%; P = 0.036). Surgeries performed after hours were longer than that of surgeries performed during the daytime (82.0 vs. 68 minutes; P = 0.003) and had more complications (pneumonia, pulmonary embolism, and surgical site infection; P = 0.002, 0.047, 0.024, respectively). CONCLUSIONS: Our results show that a part-time DOTR in a community Level II hospital is associated with improvement in patient care. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
