Delay to Surgical Treatment in Geriatric Hip Fracture Patients

Author:

Joseph Elias G.1ORCID,Serotte Jordan2ORCID,Haider Mohammad N.3,Pavlesen Sonja3,Anders Mark3

Affiliation:

1. Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine, Chattanooga, TN, USA

2. Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, IL, USA

3. Department of Orthopaedic Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

Abstract

Background Hip fractures in the geriatric population are frequently encountered. There is increasing focus on minimizing the delay to surgery in these patients. This study was designed to evaluate factors responsible for a delay to surgery in a geriatric hip fracture population and how time to surgery affects mortality. Methods A retrospective cohort of patients sustaining low energy geriatric hip fractures in either an American College of Surgeons (ACS) verified Level 1 trauma center or a local university affiliated community teaching hospital were reviewed. The following variables were evaluated as independent risk factors for delay to surgery: demographic data, surgical details, use of cardiology resources, treatment center, and comorbidities. As a secondary objective, the effect of time to surgery on 1 year mortality was analyzed. Results 1157 patients met inclusion criteria. The following factors increased the risk of delay to surgery greater than 48 hours: male sex, treatment in a community hospital (versus trauma center), older age, multiple comorbidities (eg, cardiovascular-related conditions or other fractures), cardiology consultation, and an American Society of Anesthesiologists physical status score of 3 or 4. Cardiology consultation was the strongest independent predictor of risk for delay to surgery of >48 hours (odds ratio, 6.68; 95% confidence interval, 4.40 to 10.14; P < .001). The 1-year mortality of patients did not differ when surgical treatment occurred before 48 hours or after 48 hours (Log-rank test P = .109). Conclusion The presence of cardiovascular comorbidities and cardiology consultations can delay surgical treatments for hip fractures in patients greater than 65 years old, but the delay did not influence 1-year all-cause mortality. Level of Evidence Level IV.

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Rehabilitation,Orthopedics and Sports Medicine,Surgery

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Ultra-early versus early surgery for hip fracture;Cochrane Database of Systematic Reviews;2024-06-13

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