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Wait time for surgery is a risk factor for post hip fracture complications in elderly
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SAN DIEGO — The length of time an elderly patient has to wait from arrival in the emergency room to the start of surgery to treat a hip fracture is a risk factor for postoperative complications, according to a poster presentation, here at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.
The study, performed at the Karolinska Institutet in Sweden, evaluated 583 hip fractures in 576 patients over a 1-year period from June 2007 to June 2008. Data collection included ASA score, fracture type, surgery performed, time to surgery and medical complications noted, the investigators, led by Olof Sköldenberg, MD, reported. Time from arrival to surgery was broken down to 24, 36 or 48 hours and was noted as being due to a medical or an administrative nature.
Overall, they found that 51% of the patients had surgery within 24 hours; 76% within 36 hours and 88% within 48 hours. “The rate of serious medical complications was 12% in patients undergoing surgery within 24 hours,” the investigators noted. “After 24 hours, it increased to 16%; after 36 hours to 39% and after 48 hours to 46%.”
They found that most of the delays were administrative in nature. “For patients having surgery after 24 hours, the reason for delay was medical in 14% of the cases and administrative in 75%,” according to the poster abstract.
The investigators also noted that, for every 24 hours of delay to surgery, the postoperative hospital stay was prolonged by 2 days. However, there were no differences in the 1-year mortality rates among the different times to surgery.
“We believe that reducing waiting times to surgery is effective, both from a humanitarian and an economic perspective,” the authors concluded. “Hospitals should focus on implementing practices to eliminate unnecessary delays.”
Reference:
- Kelly-Pattersson P, Lindbom D, Sköldenberg O. Waiting for surgery increases the risk of medial complications in hip fracture patients. Poster #P512. Presented at the 2011 Annual Meeting of the American Academy of Ortopaedic Surgeons. Feb. 15-19, 2011. San Diego.
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