• G Holt, R Smith, K Duncan, D F Finlayson, and A Gregori.
• Department of Orthopaedic and Trauma Surgery, Hairmyres Hospital, Eaglesham Road, East Kilbride G75 8RG, UK. graemeholt@btinternet.com
• J Bone Joint Surg Br. 2008 Oct 1;90(10):1357-63.

AbstractWe investigated the relationship between a number of patient and management variables and mortality after surgery for fracture of the hip. Data relating to 18,817 patients were obtained from the Scottish Hip Fracture Audit database. We divided variables into two categories, depending on whether they were case-mix (age; gender; fracture type; pre-fracture residence; pre-fracture mobility and ASA scores) or management variables (time from fracture to surgery; time from admission to surgery; grade of surgical and anaesthetic staff undertaking the procedure and anaesthetic technique). Multivariate logistic regression analysis showed that all case-mix variables were strongly associated with post-operative mortality, even when controlling for the effects of the remaining variables. Inclusion of the management variables into the case-mix base regression model provided no significant improvement to the model. Patient case-mix variables have the most significant effect on post-operative mortality and unfortunately such variables cannot be modified by pre-operative medical interventions.

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