Key result
Delaying hip fracture surgery to 5 days or later after admission was not significantly associated with higher 1-year mortality, and instead indicated better survival.
Why the study?
Does delaying hip fracture surgery affect mortality within 1 year in patients undergoing hip fracture surgery?
Observational
Yes
Does delaying hip fracture surgery affect mortality within 1 year in patients undergoing hip fracture surgery?
Delaying hip fracture surgery (≥5 days) was not associated with higher 1-year mortality and may indicate better survival after adjusting for patient factors.
May support individualized surgical timing after optimization; leaves open whether survival differences are causal or confounded.
PURPOSE: This study compared patients who had hip fracture surgery in the United State and Japan, and analyzed whether the timing of surgery was related to mortality within 1 year after surgery. METHODS: This is a retrospective observational study. Data were collected from medical records in 2 hospitals in the United States and 3 hospitals in Japan. A questionnaire was sent to patients and/or their family members about the patients' health outcomes after discharge. RESULTS: The median length of hospital stay before surgery was 1 day in the United States and 5 days in Japan. In the United States, patients who had more number of comorbidities had longer lengths of stay before surgery. In Japan, the timing of surgery was not necessarily related to patients' conditions. Although the length of stay before surgery was longer in Japan, the mortality rate was not higher than that in the United States. After adjusting for patient factors, types of fracture, and country, there were no significant associations between the delaying surgery and higher mortality rate. On the contrary, patients who underwent surgery in 5 days or later after admission indicated better survival. CONCLUSION: Providers should reduce unnecessary delays to surgery and they should carefully identify patients who are not suitable for early surgery.
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Kondo et al. (2011) conducted an observational in Hip fracture. Timing of hip fracture surgery vs. Early surgery was evaluated on Mortality within 1 year after surgery. Delaying hip fracture surgery to 5 days or later after admission was not significantly associated with higher 1-year mortality, and instead indicated better survival.
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