Key result
Early surgery within two days of admission for geriatric distal femur fracture was not associated with a reduction in 30-day mortality compared to delayed surgery (0.5% vs 0.5%; RD 0.0%).
Why the study?
Previous literature provided conflicting results regarding associations between early surgery and postoperative outcomes in elderly patients with distal femur fractures.
Does early surgery improve 30-day mortality and postoperative outcomes in elderly patients with distal femur fracture?
Cohort (n=9,678)
Yes
Does early surgery improve 30-day mortality and postoperative outcomes in elderly patients with distal femur fracture?
Absolute Risk Reduction: 0 (95% CI -0.7–0.7)
Absolute Event Rate: 0.5% vs 0.5%
Absolute Risk Reduction: 0%
Early surgery for geriatric distal femur fracture does not reduce 30-day mortality but is associated with fewer postoperative complications, shorter hospital stays, and lower hospitalization costs.
No mortality difference between early and delayed surgery should not change practice; leaves open optimal timing in randomized trials.
Previous literature has provided conflicting results regarding the associations between early surgery and postoperative outcomes in elderly patients with distal femur fractures. Using data from the Japanese Diagnosis Procedure Combination inpatient database from April 2014 to March 2019, we identified elderly patients who underwent surgery for distal femur fracture within two days of hospital admission (early surgery group) or at three or more days after hospital admission (delayed surgery group). Of 9678 eligible patients, 1384 (14.3%) were assigned to the early surgery group. One-to-one propensity score matched analyses showed no significant difference in 30-day mortality between the early and delayed groups (0.5% versus 0.5%; risk difference, 0.0%; 95% confidence interval, -0.7% to 0.7%). Patients in the early surgery group had significantly lower proportions of the composite outcome (death or postoperative complications), shorter hospital stays, and lower total hospitalization costs than patients in the delayed surgery group. Our results showed that early surgery within two days of hospital admission for geriatric distal femur fracture was not associated with a reduction in 30-day mortality but was associated with reductions in postoperative complications and total hospitalization costs.
No takes yet. Share an insight, caveat, or question.
Yamamoto et al. (2021) conducted a cohort in Distal femur fracture (n=9,678). Early surgery (within two days of hospital admission) vs. Delayed surgery (three or more days after hospital admission) was evaluated on 30-day mortality (risk difference 0.0%, 95% CI -0.7 to 0.7). Early surgery within two days of admission for geriatric distal femur fracture was not associated with a reduction in 30-day mortality compared to delayed surgery (0.5% vs 0.5%; RD 0.0%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: