Key result
Surgical delay longer than 24 hours occurred in 29.4% of hip fracture patients, with the primary causes being a lack of theatre facilities (54%) and medically unstable patients (16%).
Observational (n=484)
No
Nearly 30% of hip fracture patients experience surgical delays longer than 24 hours, most commonly due to a lack of theatre facilities rather than medical instability.
Resource constraints limit timely hip fracture surgery; hypothesis-generating for interventions optimizing theatre access.
Background: Several studies analyze how surgical delay affects patients with hip fracture. The aim of this study was to identify the causes of surgical delay and demographic characteristics in patients with hip fracture who had delays longer than 24 hours from admission to hospital. Methods: Quantitative retrospective register study of 484 patients was consecutively included during the period November 1, 2010 and October 31, 2011 in the University Hospital in Lund (Sweden). Results: A frequency of 29.4% had a surgical delay longer than 24 hours. The main reasons for delays to surgery were lack of theatre facilities (54%), medical unstable patient (16%) and anticoagulant treatment (10%). Of all patients, 69% (n = 332) were women and 31% (n = 151) were men. The mean age for women were 83.6 (CI 83-85) vs. 79 (CI 77-81) for men, respectively. The most common type of hip fracture was displaced cervical hip fracture (39%, n = 188) with a majority of fractures in male patients. In total, women suffered hip fractures to a greater extent than men (69% vs. 31%, p = 0.016), but no relationship was found with respect to the fracture type and age (p = 0.358). Conclusion: The main result demonstrated that delays longer than 24 hours were due to lack of theatre facilities. Further researches have to be done in order to investigate whether lack of theatre facilities depends on improper operation planning and/or on lack of medical staff.
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Sjöstrand et al. (2013) conducted an observational in Hip fracture (n=484). Surgical delay > 24 hours vs. Surgery within 24 hours was evaluated on Proportion of patients with surgical delay > 24 hours and causes of delay. Surgical delay longer than 24 hours occurred in 29.4% of hip fracture patients, with the primary causes being a lack of theatre facilities (54%) and medically unstable patients (16%).
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