Patients with hip fractures who face long waits in emergency departments have a higher risk of death, study finds

It coincides with the release of HSE figures showing 55 patients were waiting for more than 24 hours for a bed yesterday morning in Irish hospitals, including seven over the age of 75.

Twelve of the patients were in University Hospital Limerick and 10 in Mayo University Hospital.

The rest were spread between Galway University Hospital, Sligo University Hospital, University Hospital Kerry, Naas General Hospital, Tallaght University Hospital and St Luke's Hospital, Kilkenny.

Others with patients waiting over 24 hours were Tipperary University Hospital, St Vincent's Hospital, Dublin, and Wexford Hospital.

The waiting time for more than one in three patients examined in the British study exceeded the four-hour standard, the findings in the Emergency Medicine Journal revealed.

By the age of 80, an estimated one-third of women and 17pc of men will have fractured a hip, the researchers at the Royal Infirmary of Edinburgh said.

Early surgery is associated with lower risk of death and perioperative complication rates.

To assess the potential impact on hip fracture patients of more than four-hour waits in emergency departments, the researchers retrospectively evaluated local hip fracture database entries.

They looked for all patients aged at least 50 admitted to a single trauma centre between January 1, 2019 and June 30, 2022, and subsequently monitored for at least eight months until February last year.

The trauma centre in question serves a population of 916,310 people in Lothian, Scotland, and manages more than 1,000 hip fractures each year.

Details on demographics, treatment, progress through the service and deaths were collected from the patients' case notes and the trauma centre's documentation.

A total of 3,611 patients were admitted to the centre with a hip fracture during the study period. After various exclusions, including those with incomplete admission and discharge time data, 3,266 patients were included in the analysis.

Their average age was 81, but ranged from 50 to 104, and 2,359 were women. They spent an average of 3.9 hours in the emergency department.

The average length of time before surgery was 27 hours, with an average time between admission and surgery of 22.5 hours. The average length of their hospital stay was nine days.

In all, more than a third of patients waited longer than four hours in the emergency department.

They were significantly more likely to be admitted during the winter, to pose more of a surgical risk, to have sustained a fracture that is more difficult to repair and to have waited longer for their surgery than those who spent four hours or less in the emergency department.

Nearly 96pc of those who waited less than four hours were alive at 90 days compared with almost 93pc for those waiting longer – equivalent to one additional death at 90 days for every 36 patients who waited more than four hours, the researchers found.