Hip & pelvis

  • 제35권3호
  • /
  • Pages.206-215
  • /
  • 2023
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?

  • Jaiben George (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS)) ;
  • Vijay Sharma (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS)) ;
  • Kamran Farooque (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS)) ;
  • Samarth Mittal (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS)) ;
  • Vivek Trikha (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS)) ;
  • Rajesh Malhotra (Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS))
  • 투고 : 2022.10.12
  • 심사 : 2023.06.18
  • 발행 : 2023.09.30
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초록

Purpose: Delay in performance of hip fracture surgery can be caused by medical and/or administrative reasons. Although early surgery is recommended, it is unclear what constitutes a delayed surgery and whether the impact of delayed surgery can differ depending on the reason for the delay. Materials and Methods: A total of 269 consecutive hip fracture patients over 50 years of age who underwent surgery were prospectively enrolled. They were divided into two groups: early and delayed (time from reaching the hospital to surgery less than or more than 48 hours). Patients were also categorized as fit or unfit based on anesthetic fitness. One-year mortality was recorded, and regression analyses were performed to assess the impact of delay on mortality. Results: A total of 153 patients (56.9%) had delayed surgery with a mean time to surgery of 87±70 hours. A total of 115 patients (42.8%) were considered medically fit to undergo surgery. No difference in one-year mortality was observed between patients with early surgery and those with delayed surgery (P=0.854). However, when assessment of the time to surgery was performed in a continuous manner, mortality increased with prolonged time to surgery, particularly in unfit patients, and higher mortality was observed when the delay exceeded six days (fit: P=0.117; unfit: P=0.035). Conclusion: The effect of delay on mortality was predominantly observed in patients who were not considered medically fit, suggesting that surgical delays might have a greater impact on patients with medical reasons for delay.

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참고문헌

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