Risk of postoperative complications increased with longer surgical delay of hip fractures

SAN DIEGO — Patients with hip fractures who experienced a surgical delay of 2 days or more had a greater risk of postoperative complications, according to a presenter here.

“Surgical delay of greater than or equal to 2 days in the setting of hip fractures is common and confers with an increased risk of postoperative complications,” Christopher Anthony, MD, said at the American Academy of Orthopaedic Surgeons Annual Meeting.

Christopher Anthony

Using the American College of Surgeons’ National Surgical Quality Improvement Program, Anthony and colleagues assessed 30-day individual and overall complication rates among 4,696 patients aged 60 years or older who underwent treatment for hip fractures and compared the rates between various time-based cohorts. Anthony noted surgical delay was defined as days from admission until surgical intervention, with increments at every 24 hours. Modifiable and non-modifiable patient factors that might contribute to surgical delay were also assessed, Anthony noted.

Results showed 78.4% of the patients experienced a delay of at least 1 day after their admission, while 30.8% had a delay of at least 2 days and 11.1% had a delay of at least 3 days.

“We found a significant difference in overall complications in patients who experienced a delay of greater than or equal to 2 days,” Anthony said. “There was no difference in overall complications seen with earlier surgical intervention.”

Results of univariate and subsequent multivariate analyses showed congestive heart failure, American Society of Anesthesiologist class, non-white race, bleeding disorder and dependent functional status were considered risk factors for delay of at least 2 days. – by Casey Tingle

Reference:

Anthony C, et al. Paper #545. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.

Disclosure: Anthony reports no relevant financial disclosures.