AB203. SOH21AS081. The absence of resuscitation status orders in elderly patients with hip fractures in an Irish university teaching hospital

Background: Hip fractures (HF) are becoming increasingly common in Ireland due to aging populations. Prognosis in elderly populations is poor, the mean in-hospital mortality for hip fracture patients in Ireland is 4.7%. Despite this, the prevalence of goals/ceilings of treatment orders in HF patients in Ireland is not a variable measured in the Irish Hip Fracture Database (IHFD). This study aims to retrospectively capture the prevalence of patient treatment orders in HF patients in a single university teaching hospital. Our aim was to retrospectively capture the prevalence of geriatric patients presenting with HFs in a single University Teaching Hospital who had their goals of care documented during their inpatient-stay.

Methods: All patients older than 65 who suffered a HF and presented to UHG in April and May 2020 were included. Patient treatment order status was assessed by chart audit using the hospital’s paperless medical records system.

Results: Thirty-two patients older than 65 presented to UHG between April 1st and May 31st 2020 with HFs. 1/32 (3.1%) had treatment order statuses completed prior to surgical fixation. 2/32 (6.2%) had treatment order statuses completed by discharge. One of these patients (3.1%) passed away during their admission.

Conclusions: Irish HF in-hospital mortality rates are significant. Goals of care orders were not documented in the vast majority of cases. Discussing goals of care and ceiling of care orders are an important measure in protecting patient autonomy and respecting their values. Resuscitation status orders should be included in the hip fracture pathway.

Keywords: Fragility fracture; hip fracture; orthogeriatrics; neck of femur; trauma