Femoral neck fractures: does age influence acute hospital stay, delay to surgery, and acute care costs?

Abstract

The population of Western countries is aging. Previous studies have reported that advancing age does not significantly affect acute inpatient stay in femoral neck fractures. The primary goal of our study was to compare inpatient stay in acute orthopedic wards and time delay to surgery with increasing age in patients with femoral neck fractures. We then looked at the effect of covariates on our outcome measures. Our secondary goal was to identify any additional cost implications for acute care of femoral neck fractures with increasing age.This study describes 3712 patients with femoral neck fractures. The unadjusted mean stay in an acute orthopedic ward increased from 12.4 days in the patients younger than 60 years to 21.4 days in the patients 90 to 99 years (P<.0001). Similarly, unadjusted mean surgical delay increased from 20.7 hours to 39.5 hours (P<.0001). The unadjusted cost increased from $3394 in the patients younger than 60 years to $6235 in the patients 90 to 99 years.As the population ages, the number of femoral neck fractures will increase. Our study demonstrates that age is an independent predictor of increased inpatient stay and surgical delay. It also shows that we need increased resources to tackle femoral neck fractures in the aging population.