The Timing of Surgery and Mortality in Elderly Hip Fractures: A Retrospective, Multicenteric Cohort Study

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2014 Nov 19

PMID 25404773

Citations 16

Authors

Hyuk Joong Choi

Euichung Kim

Young Jeon Shin

Bo Youl Choi

Young Ho Kim

Tae Ho Lim

Affiliations

Soon will be listed here.

Abstract

Background: Early surgery is recommended for elderly hip fracture patients, but some studies show no clear advantage. The benefits of early surgery may differ according to the medical environment in different countries. The purpose of this study was to identify the potential benefits of early surgery in elderly hip fracture patients by evaluating the effect of timing of surgery on mortality.

Materials And Methods: A retrospective study was conducted at multiple centers on hip fracture patients aged over 65 years. The primary outcome was 1 year mortality and the secondary outcomes were 30-day/6-month mortality and complications during admission. The effect of time to surgery on mortality was analyzed using a Cox proportional-hazards model.

Results: Among the 874 patients, 162 (18.5%) received surgery within 3 days and their 1-year mortality rate was 9.9%. However, the 1-year mortality rate for the delayed surgery group was 12.5%. After adjustment for potential confounders, the 1-year mortality rates in patients who received surgery in 3-7 days (Hazard ratio = 1.0; 95% confidence interval [CI]: 0.7-1.6) and over 7 days (hazard ratio = 1.3; 95% CI: 0.9-1.8) were not significantly different. In addition, the time to surgery did not have a significant effect on 30-day mortality, 60-day mortality or complications arising during hospitalization.

Conclusions: The time to surgery did not affect short and long term mortality or the in hospital complication rate in elderly hip fracture patients. We recommend concentrating more on optimizing the condition of patients early with sufficient medical treatment rather than being bound by absolute timing of surgery.

Citing Articles

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Predictive Value of the C-Reactive Protein to Albumin Ratio in 30-Day Mortality after Hip Fracture in Elderly Population: A Retrospective Observational Cohort Study.

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The Surgical Timing and Prognoses of Elderly Patients with Hip Fractures: A Retrospective Analysis.

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Analysis of Factors Affecting the Third- and Twelfth-Month Mortality in Patients with Hip Fractures Aged 80 Years and Older.

Hancerli C, Turgut A, Unlu C, Erturk C Indian J Orthop. 2022; 56(4):601-607.

PMID: 35342528 PMC: 8921353. DOI: 10.1007/s43465-021-00574-4.

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