Mortality Rates are Similar after Hip Fractures for Rural and Urban Patients

Benjamin J MILLER; Xueya Cai; Peter CRAM

doi:10.1007/s11999-011-2140-3

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Mortality Rates are Similar after Hip Fractures for Rural and Urban Patients

Journal article

Open access

Peer reviewed

Mortality Rates are Similar after Hip Fractures for Rural and Urban Patients

Benjamin J MILLER, Xueya Cai and Peter CRAM

Clinical orthopaedics and related research, Vol.470(6), pp.1763-1770

2012

DOI: 10.1007/s11999-011-2140-3

PMCID: PMC3348311

PMID: 22016000

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Abstract

Background Proximal femoral fractures are common in the elderly. The best care depends on expeditious presentation, medical stabilization, and treatment of the condition. Questions/purposes We investigated the risk of increased mortality in residents of rural communities secondary to inaccessible facilities and treatment delays. Patients and Methods We used Medicare Provider Analysis and Review Part A data to identify 338,092 patients with hip fractures. Each patient was categorized as residing in urban, large rural, or small rural areas. We compared the distance traveled, mortality rates, time from admission to surgery, and length of stay for patients residing in each location. Results Patients in rural areas traveled substantially farther to reach their treating facility than did urban patients: mean, 34.4 miles for small rural, 14.5 miles for large rural, and 9.3 miles for urban. The adjusted odds ratios for mortality were similar but slightly better for urban patients for in-hospital mortality (small rural odds ratio, 1.05; large rural odds ratio, 1.13). Rural patients had a favorable adjusted odds ratio for 1-year mortality when compared with urban patients (small rural odds ratio, 0.93; large rural odds ratio, 0.96). Rural patients experienced no greater delay in time to surgery or longer hospital length of stay. Conclusions Although patients living in rural areas traveled a greater distance than those living in urban centers, we found no increase in time to surgery, hospital length of stay, or mortality. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Biological and medical sciences

Injuries of the limb. Injuries of the spine

Medical sciences

Traumas. Diseases due to physical agents

Diseases of the osteoarticular system

Details

Title: Subtitle: Mortality Rates are Similar after Hip Fractures for Rural and Urban Patients
Creators: Benjamin J MILLER - Department of Orthopaedics and Rehabilitation, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, United States
Xueya Cai - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States
Peter CRAM - Department of Internal Medicine, Division of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States
Resource Type: Journal article
Publication Details: Clinical orthopaedics and related research, Vol.470(6), pp.1763-1770
DOI: 10.1007/s11999-011-2140-3
PMID: 22016000
PMCID: PMC3348311
NLM abbreviation: Clin Orthop Relat Res
ISSN: 0009-921X
eISSN: 1528-1132
Publisher: Springer; Heidelberg
Language: English
Date published: 2012
Academic Unit: Orthopedics and Rehabilitation; Internal Medicine
Record Identifier: 9984040489802771

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