Yusuke Sasabuchi1, Hiroki Matsui2, Alan Kawarai Lefor3, Kiyohide Fushimi4, Hideo Yasunaga2. 1. Data Science Center, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-city, Tochigi, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. Electronic address: sasabuchi-tky@umin.ac.jp. 2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. 3. Department of Surgery, Jichi Medical University, Tochigi, Japan. 4. Department of Health Policy and Informatics Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Abstract
INTRODUCTION: Although early surgery for elderly patients with hip fracture is recommended in existing clinical guidelines, the results of previous studies are inconsistent. The aim of this study was to compare postoperative outcomes of early and delayed surgery for elderly patients with hip fracture. MATERIALS AND METHODS: In this retrospective study using a national inpatient database in Japan, patients aged 65 years or older who underwent surgery for hip fracture between July 2010 and March 2014 were included. Early surgery was defined as surgery on the day or the next day of admission. Assessed outcomes included death within 30 days and hospital-acquired pneumonia. RESULTS: In this cohort, 47,073 (22.5%) patients underwent surgery for hip fractures within two days of admission (early surgery group) and 161,805 (77.5%) underwent surgery for hip fractures thereafter (delayed surgery group). Early surgery was significantly associated with lower odds for hospital-acquired pneumonia (odds ratio, 0.42; 95% confidence interval, 0.25-0.69) and pressure ulcers (odds ratio, 0.56, 95%CI: 0.33-0.96, p = 0.035), but was not associated with 30-day mortality (odds ratio, 0.96; 95% confidence interval, 0.49-1.86) or pulmonary embolism (odds ratio, 1.62, 95%CI: 0.58-4.52, p = 0.357). CONCLUSIONS: These results support current guidelines, which recommend early surgery for elderly hip fractures patients.
INTRODUCTION: Although early surgery for elderly patients with hip fracture is recommended in existing clinical guidelines, the results of previous studies are inconsistent. The aim of this study was to compare postoperative outcomes of early and delayed surgery for elderly patients with hip fracture. MATERIALS AND METHODS: In this retrospective study using a national inpatient database in Japan, patients aged 65 years or older who underwent surgery for hip fracture between July 2010 and March 2014 were included. Early surgery was defined as surgery on the day or the next day of admission. Assessed outcomes included death within 30 days and hospital-acquired pneumonia. RESULTS: In this cohort, 47,073 (22.5%) patients underwent surgery for hip fractures within two days of admission (early surgery group) and 161,805 (77.5%) underwent surgery for hip fractures thereafter (delayed surgery group). Early surgery was significantly associated with lower odds for hospital-acquired pneumonia (odds ratio, 0.42; 95% confidence interval, 0.25-0.69) and pressure ulcers (odds ratio, 0.56, 95%CI: 0.33-0.96, p = 0.035), but was not associated with 30-day mortality (odds ratio, 0.96; 95% confidence interval, 0.49-1.86) or pulmonary embolism (odds ratio, 1.62, 95%CI: 0.58-4.52, p = 0.357). CONCLUSIONS: These results support current guidelines, which recommend early surgery for elderly hip fracturespatients.
Authors: Ching-Yi Shen; Chien-Han Hsiao; Weide Tsai; Wen-Han Chang; Tse-Hao Chen Journal: Int J Environ Res Public Health Date: 2021-03-11 Impact factor: 3.390