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Mortality associated with delay in operation after hip fracture: observational study
1Dr Foster Unit at Imperial College London, Department of Primary Care and Social Medicine, Imperial College London, London W6 8RP. robert.bottle@imperial.ac.uk
BMJ (Clinical Research Ed.)
|March 24, 2006
Summary
Delaying surgery for hip fractures increases patient mortality risk. This study found that delaying operation for fractured neck of femur is linked to higher death rates, but not readmissions.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Health Services Research
Background:
- Hip fractures are a common and serious injury in the elderly.
- Timely surgical intervention is crucial for patient outcomes.
Purpose of the Study:
- To quantify the impact of delayed surgery on mortality and readmission rates following hip fractures.
- To investigate variations in surgical delay across different hospital trusts.
Main Methods:
- Analysis of inpatient hospital episode statistics for hip fracture admissions.
- Inclusion of patients aged 65 and above admitted from home.
- Assessment of in-hospital mortality and 28-day emergency readmissions.
Main Results:
- Over 129,000 hip fracture admissions were analyzed, with a 14.3% in-hospital mortality rate.
- A delay in surgery of more than one day significantly increased the risk of death (OR 1.27), even after adjusting for comorbidities.
- An estimated 581 deaths per year could be prevented by ensuring timely surgery across all trusts.
Conclusions:
- Delayed surgery for hip fractures is associated with a higher risk of mortality.
- Surgical delay does not appear to be linked to increased emergency readmissions.
- Significant variations in surgical delay exist between different hospital trusts in England.