Key result
Early surgical fixation of proximal hip fractures within 48 hours did not significantly improve physical quality of life at 6 months compared to delayed fixation, but resulted in a significantly smaller decline in mental health scores.
Why the study?
Guidelines recommend hip fracture surgery within 24 hours of injury, but whether earlier fixation leads to better physical and mental outcomes compared to delayed surgery to medically optimize patients remains debated.
Does early surgical fixation within 48 hours improve physical and mental outcomes in elderly patients with proximal hip fractures compared to delayed fixation?
Observational (n=58)
No
Does early surgical fixation within 48 hours improve physical and mental outcomes in elderly patients with proximal hip fractures compared to delayed fixation?
Absolute Event Rate: -11.59% vs -14.29%
p-value: p=0.061
Early surgical fixation of hip fractures in the elderly within 48 hours is associated with better mental health outcomes and shorter hospital stays, though physical outcomes at 6 months were comparable to delayed surgery.
Early fixation linked to less mental decline in elderly hip fractures; hypothesis-generating and should not yet change practice pending RCTs.
The study aimed to find if an earlier fixation of proximal hip fractures in the elderly, leads to a better outcome, physically and mentally. Current guidelines recommend that hip fracture surgery should be done within 24 hours of injury. But those favoring a delay in surgery believe that it provides sufficient time to medically optimize patients, and thereby decrease the risk for perioperative complication. Our study was carried out in a tertiary care center. A total of 58 patients was enrolled in the study. Analysis showed, in comparison with the delayed fixation group, the early fixation group didn’t enjoy a statistically better physical quality of life at the end of 6 months, but mental health scores were significantly above the delayed fixation group. It also showed the most common reason for the delay was late presentation followed by delayed insurance clearance. An increased hospital stay was also seen for the delayed fixation group.
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Gopurathingal et al. (2022) conducted an observational in Proximal hip fractures (n=58). Early surgical fixation (<48 hours) vs. Delayed surgical fixation (>48 hours) was evaluated on Difference in SF-12 physical score from pre-fall to 6 months (p=0.061). Early surgical fixation of proximal hip fractures within 48 hours did not significantly improve physical quality of life at 6 months compared to delayed fixation, but resulted in a significantly smaller decline in mental health scores.
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