title: Effect of surgical delay on outcome in hip fracture patients: a retrospective multivariate analysis of 192 patients.
abstract: Previous studies have not demonstrated consistent results on the effect of surgical delay on outcome. This study investigated the association between the delay to surgery and the development of postoperative complications, length of hospital stay (LOS) and one-year mortality. Patients that underwent surgery for a hip fracture in a two-year period were included in a retrospective study. Uni- and multivariate regression analysis was performed in 192 hip fracture patients. There was a trend towards fewer postoperative complications (P = 0.064; multivariate regression, MR) and shorter LOS (P = 0.088; MR) in patients with a delay of less than one day to surgery. No association between surgical delay and one-year mortality was found in the population as a whole (P = 0.632; univariate regression, UR). Delay to surgery beyond one day was associated with an increased risk of infectious complications (P = 0.004; MR). In ASA I and II class patients, operation beyond one day from admission was associated with an increased risk of one-year mortality (P = 0.03; MR) and more postoperative infectious complications (P = 0.02; MR). The trends towards fewer complications and shorter LOS suggest that early surgery (within one day from admission) is beneficial for hip fracture patients who are able to undergo an operation.
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D O F
authors.initials: DO
authors.lastname: Verbeek
authors.forename: K J
authors.initials: KJ
authors.lastname: Ponsen
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
authors.forename: M J
authors.initials: MJ
authors.lastname: Heetveld
mesh_terms: D000368:Aged; D005260:Female; D005592:Fracture Fixation; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care; D012189:Retrospective Studies; D013997:Time Factors