Background and Goal of Study:
Hip fracture is the leading cause of geriatric accidental death in the UK1. It is not known if mortality is affected by the training grade of doctors involved in patient care. We investigated whether the presence of a consultant surgeon or anaesthetist affected the 30 day mortality of patients undergoing surgical fixation for a fractured neck of femur (NOF). 

Materials and Methods:
Analysis was performed on retrospectively collected data of all fractured NOF patients treated between 2010 and 2016 at our regional centre. Statistical significance was tested using a two-tailed chi-squared test.

Results:
Data was fully complete for some 2,028 (81%) of 2516 patients from Jan 2010 – Nov 2016. There was an overall decrease in 30-day mortality from 7.8% (2011-12) to 5.3% (2013-14), associated with an increased anaesthetic consultant involvement, from 54% (2010-11) to 70% (2012-13). Reduced anaesthetic consultant 30-day mortality rates (5.2%) compared to non-consultant grade (7.9%) – p value 0.022. There was no significant difference between surgical grades.

Conclusion(s):
Fractured NOF remains an injury with a high associated mortality. The presence of a consultant anaesthetist for NOF surgery is clearly associated with a reduced mortality, and highlights the importance of clinical experience in managing these frail, complex patients.

References:
1. National Hip Fracture Database annual report 2016, Royal College of Physicians

Surgical and anaesthetic consultant impact on outcomes in Hip fracture surgery