Timely admission and surgical intervention following hip fractures are critical determinants of postoperative outcomes, but the influence of injury-to-admission delay on postoperative complications, length of stay (LOS), and early mortality remains underexplored in low- and middle-income settings where delayed presentation is common. This retrospective cohort study analyzed adults who underwent operative treatment for hip fractures at a tertiary care center, including intertrochanteric fractures managed with proximal femoral nailing and intracapsular fractures treated with bipolar hemiarthroplasty or total hip replacement. All hip fractures were admitted between Jan 2024 to Sep 2025. 40 patients had IT fractures and 38 had Neck of femur fractures. The cohort comprised 46 females (mean age 72.8 ± 10.3 years) and 32 males (mean age 70.8 ± 13.3 years). Patients were stratified by injury-to-admission interval into three groups: same-day admission, admission within 48 hours, and delayed admission beyond 48 hours. Postoperative complications, LOS, and 30-day mortality were compared descriptively across groups. Patients admitted within two days of injury had the lowest postoperative complication rates and the shortest LOS, whereas delayed admission beyond 48 hours was associated with higher rates of medical and surgical complications and prolonged hospitalization; immediate admission showed intermediate outcomes. Only one 30-day mortality occurred, in a patient undergoing bipolar hemiarthroplasty admitted beyond two days of injury. Admission within 48 hours of injury appears to offer an optimal balance between physiological stabilization and prevention of immobilization-related morbidity, while delayed admission is associated with increased postoperative complications and longer LOS. Early mortality was infrequent and appeared to be driven more by patient-related factors than by admission delay alone.
Aachi et al. (Fri,) studied this question.