Effect of Surgical Delay on Intracapsular and Intertrochanteric Femoral Fractures on Mortality and Adverse Events: A Systematic Review and Meta-Analysis.

Overall, the worldwide incidence of hip fractures is increasing due to an aging population. These fractures contribute significantly to morbidity and mortality, placing a substantial burden not only on the healthcare system but also on society. This study aims to clarify the impact of surgical timing on clinical outcomes in femoral neck fractures by addressing a crucial modifiable factor in patient care. The primary focus was to evaluate the impact of time to surgery from sustained injury on mortality. The secondary objectives were to evaluate the effect of time to surgery on other adverse outcomes, including postoperative complications and hospital length of stay. Using the PICOS (population, intervention, comparison, outcome, and study design) framework, the study focused on 30-day and inpatient mortality as the primary outcomes. A literature search, a sub-meta-analysis, and a narrative synthesis were used to delve deeper into this somewhat elaborate and inconclusive topic. Most patients experienced surgical delay, and the sub-meta-analysis showed a nonsignificant trend toward reduced inpatient mortality with early surgery, whereas the narrative synthesis revealed mixed findings. Complication rates and hospital stay outcomes also varied, underscoring the complex interplay between surgical timing, patient comorbidities, and clinical outcomes. Prioritizing adequate medical optimization preoperatively remains primitive and may contribute more to improved outcomes than surgical timing alone.