title: Early operative intervention is associated with better patient survival in patients with intracapsular femur fractures but not extracapsular fractures.
abstract: The purpose of this study was to determine patients' survival after undergoing an early or delayed operation. We retrospectively assessed 1849 files of patients operated for proximal femoral fracture, divided into two diagnostic groups: intracapsular (n = 640) and extracapsular (n = 1209). 1163 (63%) were treated within 48 h from hospital admission and 686 (37%) were treated >48 h afterwards. Delayed operation in patients with intracapsular fractures was associated with a 1.8-fold excess risk for 1-year mortality (HR = 1.83, P = 0.008), while no effect was observed for patients with extracapsular fractures. Males had a higher HR for mortality in both diagnostic groups. Early surgical intervention is beneficial for intra-capsular femoral fractures; male gender and a high ASA score are associated with an increased mortality hazard risk.
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Ely L
authors.initials: EL
authors.lastname: Steinberg
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Sternheim
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Assaf
authors.initials: A
authors.lastname: Kadar
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Sagi
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Sherer
authors.affiliation: Orthopaedic Division, Tel Aviv Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Ofir
authors.initials: O
authors.lastname: Chechik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality*; D005260:Female; D005264:Femoral Fractures / Q000401:mortality / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
keywords: hazard ratio; intra-capsular and extra-capsular; postoperative mortality; proximal femoral fractures; survival rates