title: The timing of hip fracture surgery and mortality within 1 year: a comparison between the United States and Japan.
abstract: OBJECTIVE
  This study compared patients who had hip fracture surgery in the United State and Japan, and analyzed whether the timing of surgery was related to mortality within 1 year after surgery.
  
  
  METHODS
  This is a retrospective observational study. Data were collected from medical records in 2 hospitals in the United States and 3 hospitals in Japan. A questionnaire was sent to patients and/or their family members about the patients' health outcomes after discharge.
  
  
  RESULTS
  The median length of hospital stay before surgery was 1 day in the United States and 5 days in Japan. In the United States, patients who had more number of comorbidities had longer lengths of stay before surgery. In Japan, the timing of surgery was not necessarily related to patients' conditions. Although the length of stay before surgery was longer in Japan, the mortality rate was not higher than that in the United States. After adjusting for patient factors, types of fracture, and country, there were no significant associations between the delaying surgery and higher mortality rate. On the contrary, patients who underwent surgery in 5 days or later after admission indicated better survival.
  
  
  CONCLUSIONS
  Providers should reduce unnecessary delays to surgery and they should carefully identify patients who are not suitable for early surgery.
authors.affiliation: Department of Nursing, Collage of Life and Health Sciences, Chubu University, Aichi-ken, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kondo
authors.forename: Brenda K
authors.initials: BK
authors.lastname: Zierler
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hagino
mesh_terms: D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D019637:Orthopedic Procedures / Q000401:mortality*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology