Does distance to hospital and interhospital transfer negatively impact time to definitive fixation and outcomes in patients with fractured neck of femur in a rural setting?

This study aims to investigate in patients over 65 with neck of femur (NOF) fractures in Rural Australia, does initial presentation to a peripheral hospital result in a delay to surgery? Retrospective cohort study. Dubba Base Hospital, Trauma Hospital Rural Australia (Modified Monash Model (MMM) 3) and catchment area (MMM 3-7), NSW, Australia. The study includes 350 patients over 65, presenting with closed, unilateral NOF fractures who underwent operative management at the operating centre, 203 from peripheral hospitals. Primary outcomes include time to surgery and adherence to recommended timeframes for NOF fixation. Secondary outcomes encompass complications, hospital length of stay and a subgroup analysis to identify causes of surgery delay. Patients transferred from peripheral hospitals experienced a statistically significant delay in time from presentation to surgery compared to those presenting directly to the operating centre (42 h vs. 24 h, p