INTRODUCTION: Surgical delay for hip fractures (>48h) has been associated with greater adverse clinical events. However, the influence of the reasons for delay is unclear. The objective of this study was to analyse the causes of surgical delay and its influence on morbidity and mortality, in patients with hip fracture with indication for surgical treatment. MATERIAL AND METHOD: A cohort of 376 hip fractures operated at our centre between January 2012 and December 2016 was retrospectively reviewed. Patients younger than 65 years and pathological fractures were excluded. Of these, 280 patients were operated with a surgical delay>48h. The causes of the delay were: antiaggregation (AG), anticoagulation (AC), medical reasons (MM), preoperative cardiac tests or administrative/organizational reasons. Surgical wound complications, general complications and mortality were compared. RESULTS: There was a greater proportion of surgical wound complications in the AC group (P=.063). Patients in the AG, AC, and MM groups had higher rates of general associated complications (P=.3). Seven point fifty-one percent of the patients included died one year after surgery. The mortality rate at one year was highest in the MM group (P=.005). CONCLUSION: The mortality rate was statistically significantly higher in the MM group. When comparing results, patients in the AG, AC, and MM groups presented higher rates of general complications.
INTRODUCTION: Surgical delay for hip fractures (>48h) has been associated with greater adverse clinical events. However, the influence of the reasons for delay is unclear. The objective of this study was to analyse the causes of surgical delay and its influence on morbidity and mortality, in patients with hip fracture with indication for surgical treatment. MATERIAL AND METHOD: A cohort of 376 hip fractures operated at our centre between January 2012 and December 2016 was retrospectively reviewed. Patients younger than 65 years and pathological fractures were excluded. Of these, 280 patients were operated with a surgical delay>48h. The causes of the delay were: antiaggregation (AG), anticoagulation (AC), medical reasons (MM), preoperative cardiac tests or administrative/organizational reasons. Surgical wound complications, general complications and mortality were compared. RESULTS: There was a greater proportion of surgical wound complications in the AC group (P=.063). Patients in the AG, AC, and MM groups had higher rates of general associated complications (P=.3). Seven point fifty-one percent of the patients included died one year after surgery. The mortality rate at one year was highest in the MM group (P=.005). CONCLUSION: The mortality rate was statistically significantly higher in the MM group. When comparing results, patients in the AG, AC, and MM groups presented higher rates of general complications.
Keywords:
Causas de demora; Fracturas de cadera; Hip fracture morbidity mortality; Hip fractures; Morbimortalidad en fractura de cadera; Reasons for delay
Authors: Ellen de Bock; Mando D Filipe; Apollo Pronk; Djamila Boerma; Joost T Heikens; Paul M Verheijen; Menno R Vriens; Milan C Richir Journal: Int J Surg Open Date: 2021-08-24