Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Jan 13;17(1):15.
doi: 10.1007/s11657-022-01057-1.

Access to care for low trauma hip fractures in South Africa

Sapna Shivani Dela  1 , Farhanah Paruk  2 , Magda Conradie  3 , Jacobus Daniel Jordaan  4 , Asgar Ali Kalla  5 , Mkhululi Lukhele  6 , Bilkish Cassim  7
Affiliations
Observational Study

Access to care for low trauma hip fractures in South Africa

Sapna Shivani Dela et al. Arch Osteoporos. .

Erratum in

Abstract

Rationale: Early surgery is recommended for hip fractures.

Main result: In this study only one-third of subjects with hip fractures were admitted within 24 h of the fracture, and surgery was delayed beyond 48 h in the majority.

Significance: These findings highlight the need to improve access to care for hip fracture subjects.

Purpose: There is limited data on the timing of admission and surgery following a low trauma hip fracture (HF) in South Africa (SA).

Methods: A prospective, observational study was conducted at public and private hospitals in three provinces, Gauteng (GP), KwaZulu-Natal (KZN) and the Western Cape (WC), in SA to determine time from fracture to admission and from admission to surgery in patients presenting with low trauma HF. Associations with delayed admission and surgery were explored using logistic regression.

Results: The median age of the 1996 subjects was 73 years (IQR 63-81 years), the majority were women (1346, 67%) and 1347 (67%) were admitted to the public hospitals. In one-third of subjects (661, 33%), admission was delayed to beyond 24 h after the fracture. There was a significantly longer time to admission in public compared to private hospitals (21 h [IQR 10.0-48.5] versus 6 h [IQR 3.3-14.1], p < 0.001), in subjects < 65 years, the WC and when admission occurred on a weekday. Surgery was delayed beyond 48 h in the majority (1272, 69%) of subjects and was significantly longer in public compared to private hospitals (130 h [IQR 62.6-212.4] versus 45.4 h [IQR 24.0-75.5], p < 0.001), in KZN, and when admission occurred after hours.

Conclusion: The burden of HFs is higher at public hospitals in SA, where there is a significant delay in admission after a fracture and surgery after admission. This highlights the need for a review of HF care pathways, resources and policies.

Keywords: Delayed admission; Delayed surgery; Hip fractures; South Africa.

PubMed Disclaimer

References

    1. Kanis JA, Oden J, Oden A, Johansson H et al (2008) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397 - DOI - PubMed - PMC
    1. Kanis JA, Oden A, Johnell O, Johansson H et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046 - DOI - PubMed
    1. Kanis JA, Hans D, Cooper C et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:2395–2411 - DOI - PubMed
    1. Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936 - DOI - PubMed
    1. Camacho PM, Petak SM, Binkley N et al (2016) American Association of Clinical Endocrinologists and American College of Endocrinology: clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2016. Endocr Pract 22(suppl 4):S1–S42 - DOI

Publication types

LinkOut - more resources