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Delayed surgery for femoral neck fractures in younger patients correlated with poor outcomes
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Results from this retrospective study indicated patients younger than 50 years of age who were treated within 24 hours of admission for a femoral neck fracture had good, short-term outcomes; however, investigators found delayed surgery correlated with poor inpatient outcomes.
Researchers used the American College of Surgeons (ACS) National Trauma Bank to identify 1,361 patients who were surgically treated for transcervical hip fractures and determine time to surgery. The Charlson Comorbidity Index (CCI), injury severity score, concomitant pelvic fractures, other fractures and presentation to ACS trauma center level were among the risk factors analyzed for delayed surgery. Serious adverse events and minor adverse events were analyzed. Investigators used multivariate logistic regression to determine risk factors associated with delayed surgery and to determine whether inpatient outcomes were affected by delayed surgery.
Results showed that within 24 hours of presentation, 67.8% of patients underwent surgery. According to results of a multivariate regression analysis, a CCI of 3 or greater, presence of concomitant pelvic fractures and presentation to ACS level 1 trauma centers correlated with delayed surgery. The inpatient adverse event rate was 12.1%, and the overall mortality rate was 0.2%. Investigators noted increased CCI and injury severity scores correlated with an increased risk of serious adverse events, minor adverse events and adverse events overall. ‒ by Monica Jaramillo
Disclosure: Samuel reports he receives grants from the Orthopaedic Trauma Association. Please see the full study for a list of all other authors’ relevant financial disclosures.
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