AB166. SOH26AB_0419. Neck of femur fractures: an audit of Irish Hip Fracture Database standards of care (bone profile laboratory investigations)
Orthopaedic Session II

AB166. SOH26AB_0419. Neck of femur fractures: an audit of Irish Hip Fracture Database standards of care (bone profile laboratory investigations)

Austin Kerin, Conor O’Flynn, Liam O’Dwyer, Tristan Cassidy, Cian Kennedy

Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland

Background: The Irish Hip Fracture Database (IHFD) defines seven standards of care for patients presenting with neck of femur fractures. Standard 5 requires that all patients with a fragility fracture receive a comprehensive bone health assessment, including a Fracture Risk Assessment Tool (FRAX), dual-energy X-ray absorptiometry (DEXA), and blood tests to evaluate secondary causes of osteoporosis. As part of Standard 4, these blood tests are requested by the orthogeriatric service. This audit aimed to assess adherence to Standard 5 by reviewing the most recent 75 cases of hip fractures admitted to University Hospital Limerick (UHL) and comparing results with a previous audit of 100 cases completed in early 2024.

Methods: A retrospective review of the latest 75 patients admitted with hip fractures was undertaken. Data collection focused on whether the recommended orthogeriatric blood tests—parathyroid hormone (PTH), vitamin D, calcium, phosphate, thyroid function tests, haematinics, haemoglobin A1c (HbA1c), and iron studies—were completed during admission. Consistent with IHFD guidance, patients under 60 years were excluded.

Results: Compliance with recommended blood testing varied, with notable inconsistencies in both the frequency and breadth of tests performed. Routine tests such as calcium, adjusted calcium, phosphate, and electrolytes were most reliably obtained, whereas tests not included in standard admission panels, particularly PTH and magnesium, were less frequently requested. Overall, 63% of recommended blood tests were completed, reflecting a 9% improvement compared with the previous audit.

Conclusions: This audit highlights persistent deficits in evaluating secondary causes of osteoporosis in patients admitted with hip fractures at UHL. Further improvement requires ongoing educational initiatives, strengthened collaboration with laboratory services, and repeat auditing after implementing targeted interventions.

Keywords: Fracture; orthopaedics; osteoporosis; screening; standards

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab166
Cite this abstract as: Kerin A, O’Flynn C, O’Dwyer L, Cassidy T, Kennedy C. AB166. SOH26AB_0419. Neck of femur fractures: an audit of Irish Hip Fracture Database standards of care (bone profile laboratory investigations). Mesentery Peritoneum 2026;10:AB166.

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