Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery

Abstract

Among adults undergoing hip fracture surgery, increased wait time was associated with a greater risk of 30-day mortality and other complications. A wait time of 24 hours may represent a threshold defining higher risk.

Reporting and evaluating wait times for urgent hip fracture surgery in Ontario, Canada

“…Although most patients (> 75%) were admitted to hospital within 6 hours of presentation at the emergency department (mean 7.58 h [SD 11.87]), only 14 174 (33.5%) received surgery within the recommended time frame (24 h) ( Figure 1). 1,47,48 The proportion of patients with hip fracture is also reported by their time of presentation, admission and surgery in Appendix 2, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.170830/-/ DC1. Whereas 5837 patients (13.8%) arrived overnight, only 441 patients (1.0%) received surgery during this time.…”

“…Two-thirds (66%) of the participants did not receive surgery within the safe time frame (24 h). 1,47,48 Variation within Ontario's public health care system warrants performance improvement at the hospital level.Variation in wait times was attributable to treatment at different hospitals, as opposed to treatment by different phys icians. As such, initiatives for quality improvement may target hospitallevel processes preferentially rather than individual physician practices.…”

“…ip fracture repair that is delayed more than 24 hours after hospital presentation is associated with increased medical complications 1 and health care costs. 2,3 Despite known consequences for delays, it is unknown how long patients wait for hip fracture repair and other urgent and emergent procedures across Canada.…”

“…[11][12][13][14] Although variables capturing exact wait times from hospital arrival were introduced to Canadian hospital discharge abstracts in 2009, studies have not used these data to describe and evaluate wait times for urgent surgery. 1,14,15 We investigated these new time-to-surgery data among a population-based cohort of patients requiring surgery for hip fracture, the most common urgently performed surgical procedure in Canada. 16 Our objectives were to use these data to measure wait times for surgery for hip fracture, identify modifiable factors influencing them, and determine whether variation is due to treatment by different hospitals or physicians, or both.…”

Pasienter med hoftebrudd bør opereres innen 24 timer

“…I en retrospektiv kohortstudie om behandling av hoftebrudd var målet å finne mulig sammenheng mellom preoperativ ventetid og 30-dagersdødelighet (1) -Denne studien er stor og viser tydelige resultater, men kommer strengt tatt ikke med noe vesentlig nytt, sier Frede Frihagen, som er overlege ved Hoftebruddsenheten ved Oslo universitetssykehus. -Alle retningslinjer og behandlingsanbefalinger om hoftebrudd tilsier at operasjonen skal finne sted så snart som mulig.…”