Key result
Delayed surgery beyond 48 hours is not linked to higher one-year mortality versus early surgery.
Why the study?
Although early hip fracture surgery is recommended, it is unclear what constitutes delayed surgery and whether the impact of delay differs by reason for delay.
Does early surgery reduce one-year mortality in elderly patients with hip fractures compared to delayed surgery?
Observational (n=269)
No
Does early surgery reduce one-year mortality in elderly patients with hip fractures compared to delayed surgery?
Hazard Ratio: 1.06 (95% CI 0.57–1.99)
Absolute Event Rate: 18.3% vs 13.8%
p-value: p=0.854
Delaying hip fracture surgery beyond 48 hours does not significantly increase one-year mortality overall, but prolonged delays (especially >6 days) are associated with increased mortality in medically unfit patients.
Delays >6 days may raise mortality in unfit patients; leaves open whether <48h timing improves one-year survival overall.
Purpose: Delay in performance of hip fracture surgery can be caused by medical and/or administrative reasons. Although early surgery is recommended, it is unclear what constitutes a delayed surgery and whether the impact of delayed surgery can differ depending on the reason for the delay. Materials and Methods: A total of 269 consecutive hip fracture patients over 50 years of age who underwent surgery were prospectively enrolled. They were divided into two groups: early and delayed (time from reaching the hospital to surgery less than or more than 48 hours). Patients were also categorized as fit or unfit based on anesthetic fitness. One-year mortality was recorded, and regression analyses were performed to assess the impact of delay on mortality. Results: =0.035). Conclusion: The effect of delay on mortality was predominantly observed in patients who were not considered medically fit, suggesting that surgical delays might have a greater impact on patients with medical reasons for delay.
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George et al. (2023) conducted an observational in Hip fracture (n=269). Delayed surgery (>48 hours) vs. Early surgery (≤48 hours) was evaluated on One-year mortality (adjusted HR 1.06, 95% CI 0.57-1.99, p=0.854). Delayed surgery beyond 48 hours was not associated with a significant difference in one-year mortality compared to early surgery overall (adjusted HR 1.06), though delays exceeding six days increased mortality in medically unfit patients.
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