Implementation of a Dedicated Orthopaedic Trauma Room in Hip and Femur Fracture Care: A 17-Year Analysis

Objective: 

To examine the effects of implementing a dedicated orthopaedic trauma room (DOTR) on hip and femur fracture care.

Design: 

A retrospective cohort study. Setting: Level 1 trauma center. Patients: 2928 patients with femoral neck, pertrochanteric, and femoral shaft and distal femur (FSDF) fractures.

Intervention: 

Implementation of a DOTR.

Main Outcome Measures: 

Hospital length of stay (LOS), emergency department (ED) LOS, intensive care unit (ICU) LOS, and time to operating room (TTOR).

Results: 

Implementation of a DOTR resulted in significant improvement in TTOR for all patient groups (P < 0.05). We found shorter TTOR for pertrochanteric (P < 0.001), femoral neck (P = 0.039), and FSDF groups (P = 0.046). Total hospital LOS was shorter for patients with pertrochanteric (P < 0.001) and femoral neck fractures (P = 0.044). Patients with pertrochanteric hip fractures demonstrated shorter ICU LOS (P < 0.001). No LOS improvements were observed among patients in the FSDF group. ED LOS was significantly longer in all patient groups (P < 0.001).

Conclusions: 

Implementation of a DOTR was associated with shorter TTOR, shorter hospital and ICU LOS, and longer ED LOS. There was a greater number of patients transferred into the investigating institution and fewer patients transferred out. These data support the utility of a DOTR as it relates to an improvement in hospital stay–related outcomes in patients with fractures of the hip and femur. Our results suggest that a DOTR in a Level I trauma hospital is associated with improvement in patient care.

Level of Evidence: 

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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