title: Relationship between admission day and timing of surgery for patients with hip fracture.
abstract: OBJECTIVE
  This study investigated: (i) the relationship between admission day of the week and the timing of surgery; (ii) whether the admission day of the week predicted length of stay or patients' outcomes; and (iii) the relationship between the timing of surgery and mortality.
  
  
  METHODS
  This was a retrospective, observational study of two community general hospitals in Japan. The inclusion criteria were patients aged 65 years or older who had experienced a hip fracture and undergone surgery during April 2007 to March 2011. Data on demographics, care processes, and health outcomes during hospital stays were collected from hospital records. A questionnaire was sent to patients and/or their family members about the patients' health outcomes after discharge from hospital for hip fracture surgery.
  
  
  RESULTS
  Data were collected from a total of 714 patients. In both hospitals, orthopedic surgery was not scheduled every day, and the admission day was significantly related to the timing of surgery. In hospital 1, the admission day explained 38.1% of the variance in the timing of surgery, and in hospital 2, it explained 8.3%. The admission day with early surgery predicted an early discharge. The admission day with delayed surgery predicted better survival. There was no significant relationship between the timing of surgery and mortality in either hospital.
  
  
  CONCLUSIONS
  Earlier surgery, by daily operations, may reduce the length of hospital stays, but its effect on patient outcome remains unclear. It is necessary to carefully determine which patients will benefit from earlier surgery.
authors.affiliation: School of Nursing, Graduate School of Nursing, Tokyo Women's Medical University, Tokyo.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kondo
authors.forename: Chikae
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Etsuko
authors.initials: E
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010343:Patient Admission; D012189:Retrospective Studies
keywords: admission day; hip fracture; length of stay; outcome; timing of surgery