Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov;48(6):599-604.
doi: 10.4103/0019-5413.144232.

The timing of surgery and mortality in elderly hip fractures: A retrospective, multicenteric cohort study

Hyuk Joong Choi  1 , Euichung Kim  2 , Young Jeon Shin  3 , Bo Youl Choi  3 , Young Ho Kim  4 , Tae Ho Lim  1
Affiliations

The timing of surgery and mortality in elderly hip fractures: A retrospective, multicenteric cohort study

Hyuk Joong Choi et al. Indian J Orthop. 2014 Nov.

Abstract

Background: Early surgery is recommended for elderly hip fracture patients, but some studies show no clear advantage. The benefits of early surgery may differ according to the medical environment in different countries. The purpose of this study was to identify the potential benefits of early surgery in elderly hip fracture patients by evaluating the effect of timing of surgery on mortality.

Materials and methods: A retrospective study was conducted at multiple centers on hip fracture patients aged over 65 years. The primary outcome was 1 year mortality and the secondary outcomes were 30-day/6-month mortality and complications during admission. The effect of time to surgery on mortality was analyzed using a Cox proportional-hazards model.

Results: Among the 874 patients, 162 (18.5%) received surgery within 3 days and their 1-year mortality rate was 9.9%. However, the 1-year mortality rate for the delayed surgery group was 12.5%. After adjustment for potential confounders, the 1-year mortality rates in patients who received surgery in 3-7 days (Hazard ratio = 1.0; 95% confidence interval [CI]: 0.7-1.6) and over 7 days (hazard ratio = 1.3; 95% CI: 0.9-1.8) were not significantly different. In addition, the time to surgery did not have a significant effect on 30-day mortality, 60-day mortality or complications arising during hospitalization.

Conclusions: The time to surgery did not affect short and long term mortality or the in hospital complication rate in elderly hip fracture patients. We recommend concentrating more on optimizing the condition of patients early with sufficient medical treatment rather than being bound by absolute timing of surgery.

Keywords: Hip fracture; Hip fractures; Orthopedic surgery; hip surgery; morbidity; mortality.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Adjusted long term survival of elderly hip fracture patients according to time from admission to surgery. (a) Comparison of survival between surgery within 3 days and surgery after 3 days. (b) Comparison between surgery within 7 days and surgery after 7 days. The survival plots show that time to surgery did not significantly relate to survival
See this image and copyright information in PMC

References

    1. Cooper C. Epidemiology of osteoporosis. OsteoporosInt. 1999;9(Suppl 2):S2–8. - PubMed
    1. Bottle A, Aylin P. Mortality associated with delay in operation after hip fracture: Observational study. BMJ. 2006;332:947–51. - PMC - PubMed
    1. Davis TR, Sher JL, Porter BB, Checketts RG. The timing of surgery for intertrochanteric femoral fractures. Injury. 1988;19:244–6. - PubMed
    1. Dolk T. Influence of treatment factors on the outcome after hip fractures. Ups J Med Sci. 1989;94:209–21. - PubMed
    1. Paksima N, Koval KJ, Aharanoff G, Walsh M, Kubiak EN, Zuckerman JD, et al. Predictors of mortality after hip fracture: A 10-year prospective study. Bull NYU Hosp Jt Dis. 2008;66:111–7. - PubMed

LinkOut - more resources