Timing of surgery for hip fractures in the elderly: A retrospective cohort study |
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| Affiliation: | 1. Data Science Center, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-city, Tochigi, Japan;2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;3. Department of Surgery, Jichi Medical University, Tochigi, Japan;4. Department of Health Policy and Informatics Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan;1. Research Fellow, Department of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, Australia;2. Flinders Medical Centre, Department of Orthopaedics and Trauma Surgery, Adelaide, Australia;3. Flinders Medical Centre, Flinders University, Adelaide, Australia;4. Academisch Medisch Centrum Amsterdam, University of Amsterdam, The Netherlands;5. Slotervaart Hospital, Amsterdam, The Netherlands;6. Postdoc Fellow, Deparment of Orthopaedic Surgery, Academisch Medisch Centrum Amsterdam, The Netherlands;7. Orthopaedic Trauma Fellow, Flinders Medical Centre, Adelaide, Australia;8. Associate Professor, Flinders University, Adelaide, Australia;9. Consultant Orthopaedic Surgeon, Department of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Adelaide, Australia;10. Professor of Orthopaedics and Trauma Surgery, Flinders University, Adelaide, Australia;1. Department of Oral and Maxillofacial Surgery, Hamadan University of Medical Sciences, Hamadan, Iran;2. Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran;3. Department of Oral and Maxillofacial Radiology, Hamadan University of Medical Sciences, Hamadan, Iran;4. Faculty of Dentistry, Hamadan University of Medical sciences, Hamadan, Iran;5. Department of Biostatistics and Epidemiology, Hamadan University of medical sciences, Hamadan, Iran;1. Department of Trauma, Hand and Reconstructive Surgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany;2. Institute for Cardiovascular Physiology, Goethe-University, Germany;1. Harvard Combined Orthopedic Residency Program, United States;2. Beth Israel Deaconess Medical Center, Department of Orthopedics, Foot and Ankle, United States;3. Brigham and Women’s Hospital, Department of Orthopedic Surgery, Foot and Ankle, United States;1. Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil;2. Laboratorio de Microbiologia DLC, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil;1. Department of Orthopedics, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China;2. Department of General Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China;3. School of Pharmacy, Curtin University, Bentley, Australia |
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| Abstract: | IntroductionAlthough early surgery for elderly patients with hip fracture is recommended in existing clinical guidelines, the results of previous studies are inconsistent. The aim of this study was to compare postoperative outcomes of early and delayed surgery for elderly patients with hip fracture.Materials and MethodsIn this retrospective study using a national inpatient database in Japan, patients aged 65 years or older who underwent surgery for hip fracture between July 2010 and March 2014 were included. Early surgery was defined as surgery on the day or the next day of admission. Assessed outcomes included death within 30 days and hospital-acquired pneumonia.ResultsIn this cohort, 47,073 (22.5%) patients underwent surgery for hip fractures within two days of admission (early surgery group) and 161,805 (77.5%) underwent surgery for hip fractures thereafter (delayed surgery group). Early surgery was significantly associated with lower odds for hospital-acquired pneumonia (odds ratio, 0.42; 95% confidence interval, 0.25–0.69) and pressure ulcers (odds ratio, 0.56, 95%CI: 0.33–0.96, p = 0.035), but was not associated with 30-day mortality (odds ratio, 0.96; 95% confidence interval, 0.49–1.86) or pulmonary embolism (odds ratio, 1.62, 95%CI: 0.58–4.52, p = 0.357).ConclusionsThese results support current guidelines, which recommend early surgery for elderly hip fractures patients. |
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| Keywords: | Hip fractures Hospital-acquired pneumonia Mortality Time to treatment |
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