Risk-factors for surgical delay following hip fracture

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Health Services Research

Background:

• Hip fractures are a significant health concern in elderly populations.
• Timely surgical intervention is crucial for optimal outcomes in hip fracture patients.

Purpose of the Study:

• To determine pre-operative risk factors associated with surgical delays exceeding two days in patients over 65 with hip fractures.
• To identify predictors of delayed surgery in this vulnerable patient group.

Main Methods:

• Prospective observational study of 180 hip fracture patients (age > 65).
• Data collection included demographics, comorbidities (Charlson Index), mobility, medications, and time to surgery.
• Statistical analysis identified independent predictors of surgical delay > 2 days.

Main Results:

• Mean age was 83.7 years; 70% had ≥2 pre-fracture comorbidities.
• Mean time to surgery was 3.1 days; only 44.4% received surgery within 2 days.
• Higher Charlson Index, anticoagulant use, and weekend admission (Thursday-Saturday) predicted delays.

Conclusions:

• The rate of early surgery (within 2 days) for hip fractures in the elderly is low.
• Identified risk factors for delay are largely non-modifiable.
• Understanding these factors can inform the development of strategies to reduce surgical delays.