Journal article
Hip Fractures: Appropriate Timing to Operative Intervention
The Journal of arthroplasty, Vol.32(11), pp.3314-3318
11/2017
DOI: 10.1016/j.arth.2017.07.023
PMID: 28807469
Abstract
The purpose of this study is to (1) identify the incidence of surgical delay in hip fractures, (2) evaluate the time point surgical delay puts patients at increased risk for complications, and (3) identify risk factors for surgical delay in the setting of surgical management of hip fractures.
A multi-center database was queried for patients of 60 years of age or older undergoing surgical treatment of a hip fracture. Surgical delay was defined by days from admission until surgical intervention. Univariate analyses and multivariate analyses were performed on all groups.
A total of 4215 patients underwent surgery for their hip fracture. Of those experiencing surgical delay, 3304 (78%) patients experienced surgical delay of ≥1 day, 1314 (31%) had delay of ≥2 days, and 480 (11%) experienced delay of ≥3 days. There was a significant difference in complications if patients experienced surgical delay of ≥2 days (P ≤ .01). Multivariate analyses identified multiple risk factors for delay of ≥2 days including congestive heart failure (odds ratio 3.09, 95% confidence interval 2.04-4.66) and body mass index ≥40 (odds ratio 2.31, 95% confidence interval 1.31-4.08). Subgroup analysis identified that patients undergoing total hip arthroplasty were not at risk for complications with surgical delay of ≥2 days.
Surgical delay of ≥2 days in the setting of hip fractures is common and confers an increased risk of complications in those undergoing non-total hip arthroplasty procedures. We recommend surgical intervention prior to 48 hours from hospital admission when possible. Healthcare systems can utilize our non-modifiable risk factors when performing quality assessment and cost accounting.
Details
- Title: Subtitle
- Hip Fractures: Appropriate Timing to Operative Intervention
- Creators
- Chris A Anthony - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaKyle R Duchman - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaNicholas A Bedard - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaJames J Gholson - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaYubo Gao - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaAndrew J Pugely - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IowaJohn J Callaghan - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.32(11), pp.3314-3318
- Publisher
- United States
- DOI
- 10.1016/j.arth.2017.07.023
- PMID
- 28807469
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Date published
- 11/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040223302771
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