A Simple Classification System for Hip Fractures

Abstract

Background: We have developed a Hip Fracture Classification which stratifies patients into 4 groups upon admission according to fracture complexity. This classification considers pathoanatomic and physiologic parameters and was developed to help identify high-risk patients, with more surgical demands and consequently higher incidence of morbidity. Materials and Methods: Data was gathered prospectively for a cohort of 273 consecutive patients admitted over a 12month period between 2008 and 2009 and classified according to the Hip Fracture Complexity Classification (C0 C3). The following outcome measures (mortality and length of hospital stay) were reviewed at thirty days and one year. Result: The overall mortality was 4.4% at 30 days and 20% at 1 year. There were significant differences in 1-year mortality between all stratified groups (P < 0.001), but not at 30-days. No difference in length of hospital stay was noted between complexity groups (P = 0.4). Conclusion: Clinical complexity is a significant factor influencing patient outcomes following hip fractures. Our classification helps highlight patients with higher surgical demands, aiming to draw more resources and help with optimization of care to those candidates. We believe such a system could be used to evaluate different hospitals performance more accurately. Since, national data is published annually; this system can help correlate morbidity and mortality with clinical complexity.

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