title: Surgical time of day does not affect outcome following hip fracture fixation.
abstract: BACKGROUND
  Due to the need for medical optimization and congested operating room schedules, surgical repair is often performed at night. Studies have shown that work done at night increases complications. The primary aim of our study is to compare the rates of complications and 30-day mortality between 2 surgical times of day, daytime group (DTG, 07:00-15:59) and nighttime group (NTG, 16:00-06:59).
  
  
  METHODS
  Retrospective chart review from 2005 through 2010.
  
  
  METHODS
  Level 1 Trauma Center.
  
  
  METHODS
  1443 patients with hip fracture, age ≥50 years with isolated injury and surgical treatment of the fracture.
  
  
  METHODS
  Thirty-day mortality and complications: myocardial infarction, cardiac event, stroke, central nervous system event, pneumonia, urinary tract infection, postoperative wound infection, and bleeding requiring transfusion of 3 or more red blood cell units.
  
  
  RESULTS
  A total of 859 patients met the inclusion criteria; 668 patients in the DTG and 191 patients in the NTG. The 30-day mortality was 7.8%. The complication rate was 28%. No difference was found in 30-day mortality or complication rate based on the time of day the surgery was performed (P = 1.0 and P = .92, respectively). This remained unchanged when controlling for health status and surgical complexity. Age (odds ratio = 1.03/year), Charlson Comorbidity Index (CCI; odds ratio = 1.21), and American Society of Anesthesiologists (ASA; odds ratio = 1.85) score were predictive of adverse outcomes.
  
  
  CONCLUSIONS
  Surgical time of day did not affect 30-day mortality or total number of complications. Age, ASA score, and CCI were associated with adverse outcomes.
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Switzer
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Bennett
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Wright
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Vang
authors.affiliation: HealthPartners Institute for Research and Education, MN, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Anderson
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Vlasak
authors.affiliation: Rocky Mountain Orthopaedic Associates, CO, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Gammon
keywords: geriatric; hip fracture; outcomes; surgery time; time of day; time to operation