Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?

Area of Science:

• Geriatric Orthopedics
• Trauma Surgery
• Public Health

Background:

• Hip fractures are a significant cause of morbidity and mortality in the elderly.
• Timely surgical intervention, ideally within 36 hours, is recommended by British Orthopaedic Association guidelines.
• Delayed treatment of proximal femoral fractures can lead to adverse outcomes.

Purpose of the Study:

• To investigate the impact of surgical delays on clinical outcomes in elderly patients with hip fractures.
• To evaluate three-year mortality rates following proximal femoral fractures.
• To assess the association between surgical timing and patient outcomes.

Main Methods:

• Retrospective observational study of 205 patients aged ≥60 years with low-energy hip fractures.
• Data collected from electronic medical records and operating theater notes.
• Statistical analysis to determine the effect of surgical delay on outcomes.

Main Results:

• A three-year all-cause mortality rate of 45.9% was observed.
• Delays exceeding 36 hours were linked to significantly longer hospital stays and increased one- and three-year mortality.
• No significant difference in hip-related complications was found based on surgical delay.

Conclusions:

• The observed three-year mortality aligns with existing literature.
• Delaying surgical management of hip fractures is associated with poorer clinical outcomes and higher mortality.
• Adherence to the 36-hour surgical guideline is critical for improving patient prognosis.