Three in four patients with broken hip had surgery within 48 hours of attending hospital, report finds

The audit report highlighted hip fractures are the among the most severe injuries affecting older adults in Ireland, with the cost of acute care for all broken hips last year estimated at about €53m. File picture: Denis Minihane

The proportion of patients with broken hips who were admitted through an emergency department within four hours increased markedly last year, up seven points to 36%, an audit has found.

The report from the National Office for Clinical Audit also found more than three in four (77%) of patients received surgery within 48 hours.

“This year’s findings show sustained progress in the timeliness and quality of hip fracture care, supported by the dedication of teams nationwide,” the national clinical orthopaedic lead for the Irish Hip Fracture Database Terence Murphy said.

“However, consistency remains our biggest challenge.” 

The audit report highlighted hip fractures are the among the most severe injuries affecting older adults in Ireland. The cost of acute care for all broken hips last year is estimated at about €53m.

The total economic, societal and healthcare burdens of falls and fractures in Ireland, meanwhile, are projected to reach €2bn by 2030, according to the HSE.

“As the annual number of hip fractures increases, so will the need for hospital, rehabilitation and community services,” the report said. 

The quality of hip fracture care can be considered a proxy for how well older adults are treated in acute hospital settings and reflects the overall effectiveness of the trauma service.

Among the key findings from the report were that 86% of patients were reviewed by a geriatrician or advanced nurse practitioner during admission, while 87% received a specialist falls assessment, and 90% underwent a bone health assessment.

Similarly high numbers received a pre-operative nerve block for pain management (84%) and were mobilised by a physiotherapist on the day of or day after surgery (85%).

Ten hospitals in the country now collect follow-up data, which includes 30-day mobility, quality of life and one-year mortality outcomes.

Fewer than 1% of patients, meanwhile, had a documented surgical site infection.

The report also recommended a “renewed focus” on pressure ulcer prevention and education.

Mr Murphy added: “We must continue to focus on access to timely surgery, prevention of pressure ulcers and equitable access to specialist care. To truly enhance outcomes, we must now strengthen our follow-up data and ensure every patient benefits from coordinated, multidisciplinary recovery planning.”