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Delay to surgery and mortality after hip fracture
Hamish C Rae1, Ian A Harris, Lynnette McEvoy
1Orthopaedic Department, Liverpool Hospital, Liverpool, New South Wales, Australia. hrae@gmp.usyd.edu.au
ANZ Journal of Surgery
|September 7, 2007
Summary
This study found no significant increase in 30-day mortality for elderly hip fracture patients experiencing surgical delays beyond two days. However, early surgery is still recommended to reduce complications and hospital stay.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Health Services Research
Background:
- Hip fractures in elderly individuals are linked to higher mortality rates.
- Surgical delays are common in hip fracture patients due to various factors.
- The impact of delayed surgery on hip fracture patient outcomes remains debated.
Purpose of the Study:
- To investigate the association between the timing of hip fracture surgery and 30-day mortality.
- To identify predictors of 30-day mortality in elderly hip fracture patients.
Main Methods:
- An observational study of 222 patients over 50 years old undergoing hip fracture surgery.
- Data collected included age, sex, time to surgery, American Society of Anesthesiologists (ASA) scores, and surgical procedure type.
- Primary outcome was 30-day mortality, with analysis considering surgical delay and other patient factors.
Main Results:
- Overall 30-day mortality was 7.2%.
- Patients operated on within 2 days had 5.8% mortality versus 9.4% for those delayed >2 days (not statistically significant).
- Multivariate analysis identified increasing ASA score and arthroplasty as significant predictors of mortality.
Conclusions:
- No significant increase in 30-day mortality was observed for hip fracture surgeries delayed by more than 2 days.
- Despite the lack of statistical significance, early surgery is advised to minimize length of stay and potential complications.
- Increasing ASA score and undergoing arthroplasty were significant predictors of 30-day mortality.
