The effect of time-to-surgery on outcome in elderly patients with proximal femoral fractures

Smektala, R.; Endres, Heinz G.; Dasch, Burkhard; Maier, Christoph; Trampisch, Hans–Joachim; Bonnaire, F.; Pientka, Ludger

doi:10.1186/1471-2474-9-171

Cited by 153 publications

(136 citation statements)

References 24 publications

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“…Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and physical therapy after surgery decreased the risk. Previous studies showed functional status before fracture [14,42,45,52], male gender [12,15,28,33,36,42,47], older age [10,15,28,36,43,47,50,52,55], and higher ASA scores predicted mortality in older patients [24,26,33,44,49] (Table 3), which is in agreement with our findings. In our study, we did not see a difference in mortality between patients undergoing arthroplasty versus patients undergoing osteosynthesis, which is in agreement with mortality reported by Garcia et al [15] and others [18,33,37].…”

Section: Discussionsupporting

confidence: 83%

The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

Pereira

Puts

Portela

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America. Questions/PurposeWe investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area. Methods Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture. Results Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk. Conclusions Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients' survival after fracture in Brazil. Level of Evidence Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.

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Section: Discussionsupporting

confidence: 83%

The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

Pereira

Puts

Portela

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Delayed surgery could also be associated with not only mortality but also increased risk of pneumonia and pressure sores [5]. Smektala et al also emphasize that time to surgery does not decrease mortality in elderly patients but somewhat lowers the rates of complications due to immobility [15]. We found in patients that were operated after 72 hours, time to theatre is not related with mortality.…”

Section: Discussionsupporting

confidence: 51%

Risk factors for mortality in delayed intertrochanteric fractures

Çabuk¹,

Büyükkurt²,

Tekın³

et al. 2017

Med-Science

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We aimed to figured out the risk factors of one year mortality in intertrochanteric hip fractures with delayed operation more than 72 hours. 96 out of 226 patients with proximal femoral fracture included in this study. Hemogram, blood urine nitrogen (BUN), creatinine, sodium, potassium and serum albumin levels are recorded from their blood test at administration of hospital. Time to theatre and postoperative needs for intensive care are recorded. Mobility functions before fracture and after 3 months of operation are assessed by mobility part of Barthel index. Multiple logistic regression analysis was performed to estimate the simultaneous effects of important covariates. In univariate model, age(p=0.0027), ASA(p=0.00), loss of mobility(p=0.00), bone union time(p=0.001), blood transfusion(p=0.026), albumin(p=0.004) and mobility after operation (p=0.001) were associated with mortality but in the final model for multivariate regression analysis loss of mobility level (p=0.001) and bone union time (p=0.02) were found to be independent risk factors of mortality. In postoperative period mobilization is the most important variable that we could changed in intertrochanteric fractures to decrease mortality. Whatever the timing of operation, gaining the mobility as soon as possible should be the goal of our treatment.

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“…Delay of surgery more than 48 hours after the fracture has been associated with increased mortality [27,28] but mostly for a delay exceeding 48 hours after the fracture.…”

Section: Discussionmentioning

confidence: 99%

Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

Talsnes

Vinje

Gjertsen

et al. 2013

International Orthopaedics (SICOT)

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The effect of time-to-surgery on outcome in elderly patients with proximal femoral fractures

Abstract: Background: Whether reducing time-to-surgery for elderly patients suffering from hip fracture results in better outcomes remains subject to controversial debates.

Cited by 153 publications

References 24 publications

The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

Risk factors for mortality in delayed intertrochanteric fractures

Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

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