by Stacey Burling
There are good reasons that older people fear hip fractures. They can remember the days when a broken hip was often the beginning of the end. Even today, up to 30 percent of seniors who break a hip are dead in a year. Many others never get around quite as well as they did before, which could make the difference between living at home or in assisted living, or even a nursing home.
Yet until recently, doctors often took a fairly leisurely approach to fixing broken hips. Patients would wait in bed for two or three days for surgery while doctors carefully evaluated their other medical problems. Now, spurred by research that found better results with shorter delays, hospitals are creating special programs to get more hip-fracture patients into the operating room within 24 hours or less of entering the hospital. A clinical trial in Canada is testing whether surgery within six hours should be the goal. Run by a cardiologist, this trial, known by the acronym HIP ATTACK, is treating hip-fracture victims with the kind of urgency that is now the norm for heart attack and stroke patients.
Hospitals in the Philadelphia region haven’t gone that far yet, but several have created special programs to expedite care for older patients with fragile bones, whose frailty makes prolonged bed rest especially dangerous. Among them are Penn Presbyterian Medical Center, Temple University Hospital, Einstein Medical Center, and Bryn Mawr Hospital. The multidisciplinary programs also work with patients before they leave the hospital to discuss how to strengthen bones or prevent more falls.
Almost everyone who breaks a hip will get some kind of surgical repair, surgeons said. The question is when.