Long A&E waits for hip breaks can increase odds of death – Wales Online
People facing prolonged waits in Accident and Emergency (A&E) after fracturing a hip are at a higher risk of death, according to a recent study. Researchers discovered that patients who spend more than four hours in A&E are also more likely to have an extended hospital stay. The study examined data from over 3,000 hip fracture patients aged 50 and above at a trauma centre in Lothian, Scotland, between January 2019 and June 2022. The patients, with an average age of 81 years and a majority being female, were followed up for more than 500 days, during which 1,314 patients passed away.
Academics revealed that the chances of surviving three months after hospital admission significantly decreased for patients who spent over four hours in A&E compared to those with shorter A&E stays. Those who endured longer waits had a 36% higher likelihood of dying within 90 days post hip fracture. The researchers equated the increased risk to “one additional death at 90 days for every 36 patients who waited longer than 4 hours in the emergency department.” Additionally, those who waited longer than four hours typically spent an extra day in the hospital on average.
In response to these findings, the Royal Infirmary of Edinburgh has introduced a new “fast track” service to ensure most hip fracture patients wait no more than two hours in A&E. Dr Nicholas Clement, the lead author from the Royal Infirmary of Edinburgh and the University of Edinburgh, highlighted the necessity of minimising A&E waiting times, particularly for frail hip fracture patients. He noted that waiting times in A&E have risen post the Covid-19 pandemic, urging for prompt care to improve patient outcomes.
The four-hour A&E wait standard was introduced in the NHS in England in 2004 and later adopted across the UK nations. While efforts are being made to enhance A&E care, Age UK emphasised the importance of timely operations for older people without financial barriers. Authorities acknowledged the implications of prolonged A&E waits on patient well-being and pledged to address the challenges to improve care delivery and reduce waiting times.
In conclusion, the study underlines the critical impact of prolonged A&E waits on hip fracture patients’ mortality rates and hospital stays. Efforts are underway to enhance care pathways and reduce waiting times in A&E to safeguard patient outcomes and address the unique needs of older individuals requiring urgent medical attention.