title: Operative delay and mortality in elderly patients with hip fracture: an observational study.
abstract: BACKGROUND
  Hip fracture is the third cause of death among the elderly and appears to be increasingly frequent. We analysed the influence of the major variables in hip fracture management in relation to 30-day mortality.
  
  
  METHODS
  The records of all patients with isolated hip fracture treated at a regional trauma centre from January 1995 to September 2008 were reviewed. Data on demographics, comorbidities, operative delay, complications, functional status at discharge and mortality were collected and subjected to univariate and multivariate analysis.
  
  
  RESULTS
  The cohort included 1,199 patients; the mortality rate was 11.7%. Surgery was performed within 48 h of injury in 17.7% and after more than 48 h in 82.3%; the mortality rate was 9.27% in the former and 10.4% in the latter patients; however, at variance with previous reports, operative delay was not associated with a worse outcome in patients with comorbidities.
  
  
  CONCLUSIONS
  Our data support the policy envisaging fracture repair within 48 h in stable patients and delayed surgery (>48 h) in those with comorbidity conditions requiring stabilization.
authors.affiliation: Orthopaedic Department , Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy, l.depalma@univpm.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: de Palma
authors.forename: Marco
authors.initials: M
authors.lastname: Torcianti
authors.forename: Leonard
authors.initials: L
authors.lastname: Meco
authors.forename: Alessandro
authors.initials: A
authors.lastname: Catalani
authors.forename: Mario
authors.initials: M
authors.lastname: Marinelli
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000401:mortality; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D016896:Treatment Outcome