title: The effect of surgical timing on the outcome of patients with neck of femur fracture.
abstract: OBJECTIVE
  To investigate the effect of surgical timing (in hours versus after hours and weekdays versus weekends) on the outcome of patients with neck of femur fracture.
  
  
  METHODS
  Patients who were admitted to a single tertiary referral hospital for surgical management of femoral neck fractures over a continuous period from 1/11/2002 to 12/7/2012 were identified from medical records and the operating theatre database.
  
  
  RESULTS
  A consecutive series of 2334 patients were included in the study. Of the patients who underwent surgery during the weekday and during usual hours, 18% (207/1135) experienced an adverse event, compared to 16% (193/1199) outside of these times. The difference between the two groups was not significant (p = 0.17). The same conclusion was made for the comparison between those who had surgery during the week with those who had surgery on the weekend (17%, 267/1546 and 17%, 133/788, respectively, p > 0.05). The proportion of patients who underwent surgery during hours that experienced an adverse event was significantly higher than those undergoing surgery out of hours (18%, 327/1789 and 13%, 73/545, respectively, p = 0.0081). When adjusted for age, ASA score and pre-operative stay, there was no statistical difference between those different sub-groups.
  
  
  CONCLUSIONS
  There was no difference in the rates of adverse events between patients who had surgery during hours and weekdays with those who had surgery after hours or weekends. The careful selection of patients with appropriate hospital staff, resources and adequate theatre access, surgery during after hours and weekends may be safely considered to prevent a delay in surgical treatment for patient with neck of femur fracture.
authors.affiliation: Barwon Health, Department of Orthopaedic Surgery, Geelong Hospital, 292-392 Ryrie Street, Geelong, VIC, 3220, Australia. Lah1984@hotmail.com.
authors.forename: Aik Honn
authors.initials: AH
authors.lastname: Lim
authors.affiliation: Barwon Health Biostatistics Unit, School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lane
authors.affiliation: Barwon Health, Department of Orthopaedic Surgery, Geelong Hospital, 292-392 Ryrie Street, Geelong, VIC, 3220, Australia.|School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.|Barwon Orthopaedic Research Unit, Barwon Health, Geelong, VIC, 3220, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Page
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
keywords: Hip fracture; Neck of femur fracture; Outcome; Surgical timing