Key result
Surgical delay is clearly linked to an increased mortality risk in elderly patients with hip fractures, supporting recommendations to operate within the first 24 hours when clinically possible.
Why the study?
Does early surgery reduce mortality in geriatric patients with osteoporotic hip fractures?
Does early surgery reduce mortality in geriatric patients with osteoporotic hip fractures?
Elderly patients with hip fractures should undergo surgery within the first 24 hours if clinical conditions allow, to reduce mortality risk.
May warrant surgery within 24 hours when feasible in elderly hip fracture patients; extends observational data but leaves causal confirmation open.
Introduction: Osteoporotic hip fractures are important health problems in geriatric patients.The mortality rate can reach 10% during admission in hospital and 30% after 12 months.A meta-analysis of 35 independent studies described greater survival among patients who underwent early surgery.Nevertheless, controversy remains about the acceptable waiting time for surgery.The objective of this study is to describe the new knowledge on the relationship between surgical delay and mortality.Methods: The present review was carried out by conducting an electronic search in OVID (Medline and Embase) on hip fracture, mortality and surgical delay.The search was limited to publications in the last 5 years and in English and Spanish.A total of 73 articles were obtained, of which 14 were finally selected.Results: Papers can be grouped into those that fund or not a relationship between surgical delay and mortality.Among the first, different authors described a strong association between mortality and complexity measured by a comorbidities index (Charlson Comorbidity Index or American Society of Anaesthesiologists' score).On the other hand, more studies have shown a strong association between time to surgery and mortality.A study among 42,230 patients used time as a continuous variable showing that wait time was associated with a greater risk of 30day mortality and other complications.Conclusion: Surgical delay is clearly linked to mortality risk in the different cut-points studied.Elderly patients admitted at hospital with hip fracture might be operated in the first 24 hours if the clinical conditions allow the surgery process.
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Francisco José Tarazona‐Santabalbina (2018) conducted a review in Hip fracture (n=14). Surgical delay vs. Early surgery (within 24 to 48 hours) was evaluated on Mortality. Surgical delay is clearly linked to an increased mortality risk in elderly patients with hip fractures, supporting recommendations to operate within the first 24 hours when clinically possible.
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