J Sanz-Reig1, J Salvador Marín2, J Ferrández Martínez2, D Orozco Beltrán3, J F Martínez López2. 1. Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d' Alacant, Sant Joan d'Alacant, Alicante, España. Electronic address: javisanz@coma.es. 2. Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d' Alacant, Sant Joan d'Alacant, Alicante, España. 3. Departamento de Medicina, Universidad Miguel Hernández, Elche, Alicante, España.
Abstract
OBJECTIVE: To identify pre-operative risk factors for surgical delay of more than 2 days after admission in patients older than 65 years with a hip fracture. MATERIAL AND METHODS: A prospective observational study was conducted on 180 hip fractures in patients older than 65 years of age admitted to our hospital from January 2015 to April 2016. The data recorded included, patient demographics, day of admission, pre-fracture comorbidities, mental state, level of mobility and physical function, type of fracture, antiaggregant and anticoagulant medication, pre-operative haemoglobin value, type of treatment, and surgical delay. RESULTS: The mean age of the patients was 83.7 years. The mean Charlson Index was 2.8. The pre-fracture baseline co-morbidities were equal or greater than 2 in 70% of cases. Mean timing of surgery was 3.1 days. At the time of admission, 122 (67.7%) patients were fit for surgery, of which 80 (44.4%) underwent surgery within 2 days. A Charlson index greater than 2, anticoagulant therapy, and admission on Thursday to Saturday, were independently associated with a surgical delay greater than 2 days. CONCLUSIONS: The rate of hip fracture patients undergoing surgery within 2 days is low. Risk factors associated to surgical delay are non-modifiable. However, their knowledge should allow the development of protocols that can reduce surgical delay in this group of patients.
OBJECTIVE: To identify pre-operative risk factors for surgical delay of more than 2 days after admission in patients older than 65 years with a hip fracture. MATERIAL AND METHODS: A prospective observational study was conducted on 180 hip fractures in patients older than 65 years of age admitted to our hospital from January 2015 to April 2016. The data recorded included, patient demographics, day of admission, pre-fracture comorbidities, mental state, level of mobility and physical function, type of fracture, antiaggregant and anticoagulant medication, pre-operative haemoglobin value, type of treatment, and surgical delay. RESULTS: The mean age of the patients was 83.7 years. The mean Charlson Index was 2.8. The pre-fracture baseline co-morbidities were equal or greater than 2 in 70% of cases. Mean timing of surgery was 3.1 days. At the time of admission, 122 (67.7%) patients were fit for surgery, of which 80 (44.4%) underwent surgery within 2 days. A Charlson index greater than 2, anticoagulant therapy, and admission on Thursday to Saturday, were independently associated with a surgical delay greater than 2 days. CONCLUSIONS: The rate of hip fracturepatients undergoing surgery within 2 days is low. Risk factors associated to surgical delay are non-modifiable. However, their knowledge should allow the development of protocols that can reduce surgical delay in this group of patients.
Authors: Jorge Salvador-Marín; Francisco Javier Ferrández-Martínez; Cort D Lawton; Domingo Orozco-Beltrán; Jose Fernando Martínez-López; Bryan T Kelly; Juan Carlos Marzo-Campos Journal: Sci Rep Date: 2021-12-16 Impact factor: 4.379