[Influence of nocturnal surgery on mortality and complications in patients with hip fractures].
SUBJECT OF INVESTIGATION: The appropriate time of day for surgery of hip fractures and the question of whether surgery should be performed at night are controversial. We therefore investigated the influence of the time of day on mortality and complication rates in surgery for hip fractures.


METHODS
A total of 170 persons were included in the study with 128 operations being performed during the day and 42 at night, after 9 p.m. All patients were operated as early as possible. Patients were randomly assigned to groups. The recorded data were mainly demographic, perioperative and those concerning the patient's history. Mortality and complication rates 6 months after surgery were compared.


RESULTS
The two groups were largely homogeneous. Patients operated on at night had a non-significantly higher mortality rate. Mortality was highest in those operated on between 9 and 10 p.m. Of those who underwent surgery after midnight, no patient died. No differences were registered with regard to complications. The team of surgeons and anesthetists was equally qualified in both groups.


CONCLUSIONS
Given a medical team with equal qualifications and size, we consider nocturnal surgery for hip fractures to be as appropriate as surgery during the day.
Dorotka
R
R
Unfallchirurgische Abteilung, Waldviertelklinikum Horn. r.dorotka@utanet.at
Schoechtner
H
H
Buchinger
W
W
D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D002940:Circadian Rhythm; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009551:Night Care / Q000592:standards*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D018570:Risk Assessment; D016019:Survival Analysis