An audit of patient satisfaction following the introduction of a pre-admission information letter for trauma patients

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Aim: To identify and quantify high-risk hip fracture patients using a simple clinically based 4-part classification that considers anatomic and physiologic parameters, in order to optimize management.Complexity is graded from straightforward (C0) to most complex, i.e. local and systemic complexity C3.Methods: Data entered and stratified by the Complexity Classification (C0-C3) prospectively onto our database over a 12-month period (2008)(2009).We admitted 273 consecutive patients.Admission to theatre time, length of acute stay and 30-dayand one year mortalities were reviewed as outcome measures.Results: Mean age was 81.3 years, 4:1 female to males and overall 30-day mortality of 4.4%.Spearman's rank order correlation was run to determine the relationship between complexity group and time to theatre and repeated between time to theatre and one-year mortality.There was a strong, positive correlation between complexity group and time to theatre, which was statistically significant (r s (8) = 0.137, P = 0.023).There was also a strong, positive correlation between complexity group and one-year mortality, which was statistically significant (r s (8) = 0.181, P = 0.003).Difference in one-year mortality between all stratified groups was statistically significant (P < 0.001), but no statistical difference in 30-day mortality between groups.We found linear incremental relationship in one-year mortality between complexity groups.Length of hospitalisation did not demonstrate significant differences between groups (P = 0.4).Conclusion: Clinical complexity significantly influences hip fracture patient outcome and represents interaction and summation of local and systemic patient factors.The Swindon complexity classification is therefore a useful method to identify high-risk patients for optimisation of care and resource allocation.It could be used regionally and nationally to better evaluate hospitals' performance.

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