NICE urges prompt surgery for hip fractures

Patients with broken hips should have surgical treatment the same day or the day after hospital admission, according to new NICE guidance published last week.

Some hip fracture patients currently wait up to several days before surgery. Evidence demonstrates that prompt surgery and an effective ward-based multi-disciplinary Hip Fracture Programme can significantly improve patients' lives, reducing the length of hospital stays, helping them recover their mobility faster and reducing the number of follow-up procedures.

Implementing the new recommendations could also help make hip fracture clinical practice more cost effective. Currently it is estimated to cost medical and social care £2 billion every year to treat all UK hip fracture cases. NICE states changes outlined in the new guideline would cost very little to implement and save money in the long-term, while leading to much better quality of life for patients.

Hip fractures are a major public health issue and, although they are more common in later life, they can happen at any age. Around 70-75,000 hip fractures occur each year in the UK, and figures are expected to rise even higher as a result of the ageing population. Outcomes for patients with broken hips can be poor, with one in three dying within 12 months. Although most of these deaths are not due to the fracture itself, it is an indication of the high prevalence of pre-existing illnesses in these patients.

Professor Cameron Swift, Emeritus Professor of Health Care of the Elderly, Kings College London and Guideline Development Group Chair said: "Hip fractures are devastating, costly and increasing with an ageing population. The consequences for patients and the health service are far worse if hip fracture management is delayed and disjointed.

"This evidence-based NICE guideline charts the way forward by recommending cost effective changes to what happens in acute hospitals. Our guideline recommends prompt surgery, and a coordinated individual hip fracture programme for each patient from the moment they arrive at hospital through to rehabilitation and discharge.

"Patients, mostly elderly people, deserve no less, and everyone potentially benefits."

The new guideline is available at http://guidance.nice.org.uk/CG124