title: Mortality and quality of life after proximal femur fracture-effect of time until surgery and reasons for delay.
abstract: BACKGROUND
  Studies yield conflicting results from the effect of early surgery on mortality. Some observed a positive, others a negative and some did not find any effect of early operation. In this study, mortality and quality of life in relation to time until surgery as well as reasons for delay were observed prospectively.
  
  
  METHODS
  Data of 138 patients (>65 years) with proximal femoral fractures and consecutive surgery were observed. Demographic data as well as mortality rate, survival time and Barthel Index up to 1 year in relation to different time frames were observed. Reasons for operative delay were divided into being administrative or patient-related.
  
  
  RESULTS
  Three-month mortality was 10.1% and 1-years was 23.9%. Neither time from injury until hospital admission nor from injury until surgery or from hospital admission until surgery up to 48 hours had any effect on mortality and survival time. The age of patients dying in the follow-up period was significantly higher than the age of patients surviving (86.8 vs. 84.4 years). No influence of any delay in time until surgery on the Barthel Index was observed.
  
  
  CONCLUSIONS
  In proximal femoral fractures, a delay of surgery up to 48 hours did not influence mortality and Barthel Index negatively, nor did other associating factors. Only the patients age at the time of injury influences mortality rate, survival time, and Barthel Index significantly. The older the patient at the time of injury; the higher the mortality rate, the shorter the survival time and the lower the Barthel Index.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany. mmuhm@westpfalz-klinikum.de.|Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University, Heidelberg, Germany. mmuhm@westpfalz-klinikum.de.|Johannes Gutenberg-University, Mainz, Germany. mmuhm@westpfalz-klinikum.de.
authors.forename: M
authors.initials: M
authors.lastname: Muhm
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.|Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University, Heidelberg, Germany.|Johannes Gutenberg-University, Mainz, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Arend
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.|Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University, Heidelberg, Germany.|Johannes Gutenberg-University, Mainz, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ruffing
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.|Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University, Heidelberg, Germany.|Johannes Gutenberg-University, Mainz, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Winkler
keywords: Barthel Index; Mortality; Proximal femur fracture; Quality of life; Reasons for delay; Time until surgery
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