Key result
Delaying hip fracture surgery until after inpatient day 3 increased 30-day in-hospital mortality compared to surgery on the day of admission (OR 1.27).
Why the study?
Does early hip fracture surgery (on admission day or day 2) reduce 30-day inpatient mortality compared to delayed surgery in medically stable patients aged 65 or older?
Population
139,119 medically stable patients with hip fracture aged 65 years or older in Canada between 2004 and 2012
Comparison
Hip fracture surgery on admission day or… vs Hip fracture surgery on day 3 or after day 3
Design
Cohort
Follow-up
30 days
Authors
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Links delayed surgery to higher mortality; leaves open whether expediting timing reduces deaths in RCTs.
Cohort (n=139,119)
Yes
Does early hip fracture surgery (on admission day or day 2) reduce 30-day inpatient mortality compared to delayed surgery in medically stable patients aged 65 or older?
Odds Ratio: 1.27 (95% CI 1.16–1.38)
Absolute Event Rate: 6.9% vs 4.9%
Surgery on admission day or the following day reduces postoperative mortality among medically stable older patients with hip fracture.
Sobolev et al. (2018) conducted a cohort in Hip fracture (n=139,119). Surgical delay after inpatient day 3 vs. Surgery on day of admission was evaluated on 30-day in-hospital mortality (OR 1.27, 95% CI 1.16 to 1.38). Delaying hip fracture surgery until after inpatient day 3 increased 30-day in-hospital mortality compared to surgery on the day of admission (OR 1.27).
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