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Effects of Delayed Hip Fracture Surgery on Mortality and Morbidity in Elderly Patients

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The effects of delaying hip fracture surgery on mortality and morbidity in elderly patients are not completely understood.

Questions/purposes

We examined the effects of delays in surgical treatment of hip fracture on mortality, postoperative complications, length of stay in hospital, and functional recovery, in elderly patients.

Patients and Methods

We studied two groups of patients with hip fractures. The first group was studied retrospectively (n = 109); these patients had been exposed to an average delay in receiving surgical treatment of more than 1 week owing to a fire at our hospital. Patients in the second group (n = 79), which we studied prospectively, were operated on within 48 hours of experiencing the fracture or as soon as their medical condition permitted. Rates of mortality and complications were registered for each group.

Results

We found a larger number of complications in the group with a delay in surgical treatment (pressure ulcer, urinary infection, deep vein thrombosis, and postoperative length of stay), but there were no differences in mortality or functional recovery at 3 months and 1 year.

Conclusions

A 1-week delay in the surgical treatment of elderly patients with hip fractures did not increase the mortality rate or prolong the period of recovery but did increase the incidence of postoperative complications. Our experience suggests elderly patients with hip fractures should be operated on as soon as their medical condition permits.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Drs J.A. Serrano, L. Castro, and P. Serrano for help in completing this article.

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Authors and Affiliations

  1. Department of Orthopaedics, University Hospital “Reina Sofia”, Menendez Pidal Avenue, 14004, Cordoba, Spain

    Pedro Rodriguez-Fernandez MD, PhD & Pedro Carpintero MD, PhD

  2. Department of Internal Medicine, Basic Hospital “Alto Guadalquivir”, Montilla, Spain

    Dolores Adarraga-Cansino MD, PhD

Authors
  1. Pedro Rodriguez-Fernandez MD, PhD
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  2. Dolores Adarraga-Cansino MD, PhD
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  3. Pedro Carpintero MD, PhD
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Corresponding author

Correspondence to Pedro Carpintero MD, PhD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at University Hospital “Reina Sofia.”

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Rodriguez-Fernandez, P., Adarraga-Cansino, D. & Carpintero, P. Effects of Delayed Hip Fracture Surgery on Mortality and Morbidity in Elderly Patients. Clin Orthop Relat Res 469, 3218–3221 (2011). https://doi.org/10.1007/s11999-010-1756-z

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  • DOI: https://doi.org/10.1007/s11999-010-1756-z

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