title: Operative treatment of patients with pertrochanteric femoral fractures outside working hours is not associated with a higher incidence of complications or higher mortality.
abstract: This retrospective cohort study was conducted to investigate whether operative treatment of patients with a pertrochanteric femoral fracture outside working hours is associated with an increased risk of complications and higher mortality. During the study period 165 patients were operated on outside working hours and 123 were operated on during working hours (08.00 to 17.00). There was no difference in the rate of early complications (outside working hours 33% versus working hours 33%, p = 0.91) or total complications during follow-up (outside working hours 40% versus working hours 41%, p = 0.91). Both in-hospital mortality (outside working hours 12% versus working hours 11%, p = 0.97) and mortality after one year (outside working hours 29% versus working hours 27%, p = 0.67) were comparable. Adjustment for possible confounders by multivariate logistic regression analysis revealed no increased risk of complications when patients were operated on outside working hours. On the basis of these data, there is no medical reason to postpone operative reduction and fixation in patients with a proximal femoral fracture until working hours.
authors.affiliation: St Elisabeth Hospital, Tilburg, The Netherlands. e.bosma@elisabeth.nl
authors.forename: E
authors.initials: E
authors.lastname: Bosma
authors.forename: M A C
authors.initials: MA
authors.lastname: de Jongh
authors.forename: M H J
authors.initials: MH
authors.lastname: Verhofstad
mesh_terms: D000328:Adult; D039602:After-Hours Care; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000401:mortality; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult