Is there a weekend effect in hip fracture patients presenting to a United Kingdom teaching hospital?

AIM: To compare mortality and time-to-surgery of patients admitted with hip fracture to our teaching hospital on weekdaysvsweekends.

METHODS: Data was prospectively collected and retrospectively analysed for 816 hip fracture patients. Multivariate logistic regression was carried out on 3 binary outcomes (time-to-surgery < 36 h; 30-d mortality; 120-d mortality), using the explanatory variables time-of-admission; age; gender; American Society of Anesthesiologist (ASA) grade; abbreviated mental test score (AMTS); fracture type; accommodation admitted from; walking ability outdoors; accompaniment outdoors and season.

RESULTS: Baseline characteristics were not statistically different between those admitted on weekdaysvsweekends. Weekend admission was not associated with an increased time-to-surgery (P= 0.975), 30-d mortality (P= 0.842) or 120-d mortality (P= 0.425). Gender (P= 0.028), ASA grade (P< 0.001), AMTS (P= 0.041) and accompaniment outdoors (P= 0.033) were significant co-variates for 30-d mortality. Furthermore, age (P< 0.001), gender (P= 0.011), ASA grade (P< 0.001), AMTS (P< 0.001) and accompaniment outdoors (P= 0.033) all significantly influenced mortality at 120 d. ASA (P< 0.001) and season (P= 0.014) had significant effect on the odds of undergoing surgery in under 36 h.

CONCLUSION: Weekend admission was not associated with increased time-to-surgery or mortality in hip fracture patients. Demographic factors affect mortality in accordance with previous published reports.