European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
Does early surgery within 48 hours improve clinical outcomes in elderly hip fractures? A matched cohort study of 1776 hip fractures.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chu Zachary, Ng Julia Poh Hwee, Chua Tjun Huat Ivan, Ho Sean Wei Loong
Аннотация
PURPOSE: The aim of this study was to determine if a delay to surgery of more than 48 h was associated with poorer functional outcomes and increased 1-year mortality rates for elderly hip fractures.
METHODS: A retrospective review of surgically treated elderly (≥ 60 years old) hip fracture patients in a single institution was conducted. Patients were divided into 2 groups depending on hours from admission to surgery: Group 1 ( ≤ 48 h) and Group 2 (> 48 h); these groups were 1:1 matched for the initial Modified Barthel's Index (MBI) and Charlson Comorbidity Index (CCI).
RESULTS: 2562 patients were eligible for the study. The cut-point value in a receiver operating curve analysis for 12-month MBI against time to surgery was not robust enough to determine an optimal time for surgery. Group 1 (n = 888) had significantly better MBI scores at 6-months [mean 78.7 (± 19.9) vs. mean 75.5 (± 20.6)] and 1-year [mean 80.4 (± 20.1) vs. mean 76.9 (± 22.3)] (p < 0.001). This difference in MBI scores between the groups did not meet the minimal clinically important difference of 10 points. There was no significant difference in 1-year mortality (3.7% vs. 4.4%) (p = 0.427). Delayed surgery past 48 h significantly increased the risk of post-operative complications. (Urinary tract infection, acute retention of urine and pneumonia) (p < 0.001).
CONCLUSION: Delayed surgery for elderly hip fractures after 48 h increases the risk of acute post-operative complications. There is no increase in 1-year mortality and no clinically important deterioration of MBI if operated on after 48 h.
LEVEL OF EVIDENCE: III.
METHODS: A retrospective review of surgically treated elderly (≥ 60 years old) hip fracture patients in a single institution was conducted. Patients were divided into 2 groups depending on hours from admission to surgery: Group 1 ( ≤ 48 h) and Group 2 (> 48 h); these groups were 1:1 matched for the initial Modified Barthel's Index (MBI) and Charlson Comorbidity Index (CCI).
RESULTS: 2562 patients were eligible for the study. The cut-point value in a receiver operating curve analysis for 12-month MBI against time to surgery was not robust enough to determine an optimal time for surgery. Group 1 (n = 888) had significantly better MBI scores at 6-months [mean 78.7 (± 19.9) vs. mean 75.5 (± 20.6)] and 1-year [mean 80.4 (± 20.1) vs. mean 76.9 (± 22.3)] (p < 0.001). This difference in MBI scores between the groups did not meet the minimal clinically important difference of 10 points. There was no significant difference in 1-year mortality (3.7% vs. 4.4%) (p = 0.427). Delayed surgery past 48 h significantly increased the risk of post-operative complications. (Urinary tract infection, acute retention of urine and pneumonia) (p < 0.001).
CONCLUSION: Delayed surgery for elderly hip fractures after 48 h increases the risk of acute post-operative complications. There is no increase in 1-year mortality and no clinically important deterioration of MBI if operated on after 48 h.
LEVEL OF EVIDENCE: III.