Treatment in teaching hospitals reduced in-hospital mortality (OR 0.89; 95% CI 0.83-0.97), whereas surgical delays of one day (OR 1.13) or >2 days (OR 1.60) increased mortality.
Cohort (n=57,315)
Yes
Does hospital type and surgical delay affect mortality in patients undergoing surgery for hip fracture?
Delaying hip fracture surgery for non-medical reasons is associated with increased mortality, and treatment at teaching hospitals is associated with lower in-hospital mortality compared to urban community hospitals.
Odds Ratio: 0.89 (95% CI 0.83–0.97)
Death during the first year after hip fracture may be influenced by the type of hospital in which patients are treated as well as the time spent awaiting surgery. We studied 57,315 hip fracture patients who were admitted to hospital in Ontario, Canada. Patients treated in teaching hospitals had a decreased risk of in-hospital mortality (odds ratio (OR) 0.89; 95% confidence interval (CI) 0.83 to 0.97) compared with those treated in urban community institutions. There was a trend toward increased mortality in rural rather than urban community hospitals. In-hospital mortality increased as the surgical delay increased (OR 1.13; 95% CI 1.10 to 1.16) for a one-day delay and higher (OR 1.60; 95% CI 1.42 to 1.80) for delays of more than two days. This relationship was strongest for patients younger than 70 years of age and with no comorbidities but was independent of hospital status. Similar relationships were seen at three months and one year after surgery. This suggests that any delay to surgery for non-medical reasons is detrimental to a patient's outcome.
Weller et al. (Tue,) conducted a cohort in Hip fracture (n=57,315). Treatment in a teaching hospital vs. Treatment in an urban community institution was evaluated on In-hospital mortality (OR 0.89, 95% CI 0.83-0.97). Treatment in teaching hospitals reduced in-hospital mortality (OR 0.89; 95% CI 0.83-0.97), whereas surgical delays of one day (OR 1.13) or >2 days (OR 1.60) increased mortality.