{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:57:00Z","timestamp":1781636220181,"version":"3.54.5"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Hip fractures are one of the most common fracture types in adults. Rapid admission to orthopaedic wards from ED (&lt;\u20094\u00a0h) and optimal timing for surgery within 36\u00a0h, is linked with good patient outcomes. This study aims to identify factors that influence achievement of timely admission of elderly hip fracture patients to specialist wards at a UK tertiary centre. Additionally, it seeks to examine the impact of timely admission on 30-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single-centre study of a cohort of 6,170 patients aged over 60 who were admitted to our hospital\u2019s ED with hip fractures from 22\/10\/2015 to 02\/06\/2023. Patient characteristics tables were generated with patients being categorised into early (\u2009&lt;\u2009=\u20094\u00a0h) and delayed admissions (&gt;\u20094\u00a0h), and then by 30-day mortality. Logistic regression analyses were performed to identify factors associated with delayed admission to specialist wards and to assess the independent effect of admission delay (over 4\u00a0h) on 30-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 5937 patients for whom admission data were available, 19% (1131\/5937) were admitted within 4\u00a0h. Results showed that lower AMT score (OR 0.98, 95% CI: 0.96-1.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), out-of-hours presentation (OR 1.27, 95% CI: 1.11\u20131.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and a higher Charlson Comorbidity Index (OR 1.05, 95% CI: 1.02\u20131.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) were associated with an increased chance of admission delays exceeding 4\u00a0h. Furthermore, admission delays of more than 4\u00a0h (OR 1.44, 95% CI: 1.06\u20131.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) were associated with increased 30-day mortality, controlling for the other risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Timely admission of hip fracture patients over the age of 60 is critical to reduce 30-day mortality. Low AMT score, out-of-hours presentation, and multiple comorbidities impact the timeliness of admissions in our hospital, highlighting a need to address these factors to improve care for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03097-5","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T09:22:31Z","timestamp":1771838551000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid transfer to specialist orthopaedic ward reduces mortality in hip fracture patients, but several factors reduce the ability to achieve the &lt;\u20094-hour target"],"prefix":"10.1007","volume":"52","author":[{"given":"Marios","family":"Katsanevakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Farag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R","family":"Norrish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"3097_CR1","unstructured":"Emmerson BR, Varacallo MA, Inman D. Hip Fracture Overview. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025."},{"key":"3097_CR2","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1016\/j.injury.2018.04.015","volume":"49","author":"N Veronese","year":"2018","unstructured":"Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018;49:1458\u201360. https:\/\/doi.org\/10.1016\/j.injury.2018.04.015.","journal-title":"Injury"},{"key":"3097_CR3","unstructured":"(2011) Recommendations | Hip fracture: management | Guidance | NICE. https:\/\/www.nice.org.uk\/guidance\/cg124\/chapter\/Recommendations#timing-of-surgery. Accessed 7 Jun 2025."},{"key":"3097_CR4","first-page":"945","volume":"89","author":"KE LeBLANC","year":"2014","unstructured":"LeBLANC KE, Herbert L, Muncie J, LeBLANC LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014;89:945\u201351.","journal-title":"Am Fam Physician"},{"key":"3097_CR5","volume-title":"The NHS Plan: a plan for investment: a plan for reform","author":"Health D of","year":"2000","unstructured":"Health D of. The NHS Plan: a plan for investment: a plan for reform. Stationery Office; 2000."},{"key":"3097_CR6","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1136\/emermed-2021-211572","volume":"39","author":"S Jones","year":"2022","unstructured":"Jones S, Moulton C, Swift S, et al. Association between delays to patient admission from the emergency department and all-cause 30-day mortality. Emerg Med J. 2022;39:168\u201373. https:\/\/doi.org\/10.1136\/emermed-2021-211572.","journal-title":"Emerg Med J"},{"key":"3097_CR7","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1136\/emermed-2023-213085","volume":"41","author":"ND Clement","year":"2024","unstructured":"Clement ND, Farrow L, Chen B, et al. Delayed admission of patients with hip fracture from the emergency department is associated with an increased mortality risk and increased length of hospital stay. Emerg Med J. 2024;41:654\u20139. https:\/\/doi.org\/10.1136\/emermed-2023-213085.","journal-title":"Emerg Med J"},{"key":"3097_CR8","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1093\/bja\/aen236","volume":"101","author":"MJ Maxwell","year":"2008","unstructured":"Maxwell MJ, Moran CG, Moppett IK. Development and validation of a preoperative scoring system to predict 30\u00a0day mortality in patients undergoing hip fracture surgery. Br J Anaesth. 2008;101:511\u20137. https:\/\/doi.org\/10.1093\/bja\/aen236.","journal-title":"Br J Anaesth"},{"key":"3097_CR9","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373\u201383. https:\/\/doi.org\/10.1016\/0021-9681(87)90171-8.","journal-title":"J Chronic Dis"},{"key":"3097_CR10","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1093\/ageing\/1.4.233","volume":"1","author":"HM Hodkinson","year":"1972","unstructured":"Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing. 1972;1:233\u20138. https:\/\/doi.org\/10.1093\/ageing\/1.4.233.","journal-title":"Age Ageing"},{"key":"3097_CR11","unstructured":"\u200bStatement on ASA Physical Status Classification System. https:\/\/www.asahq.org\/standards-and-practice-parameters\/statement-on-asa-physical-status-classification-system. 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Can J Cardiol. 2021;37:1322\u201331. https:\/\/doi.org\/10.1016\/j.cjca.2020.11.010.","journal-title":"Can J Cardiol"},{"key":"3097_CR14","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","volume":"335","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335:806\u20138. https:\/\/doi.org\/10.1136\/bmj.39335.541782.AD.","journal-title":"BMJ"},{"key":"3097_CR15","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac183","volume":"51","author":"R Patel","year":"2022","unstructured":"Patel R, Judge A, Johansen A, et al. Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study. 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The study was registered with the trust audit and clinical governance department under reference number 24-600c. Supported by the HRA decision tool, the project was deemed exempt from research ethics review in accordance with trust and national guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All patient information was anonymised, and the submission does not include images that may identify the person. Consequently, no informed consent was required from the patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"54"}}