Veronique Rijckevorsel (Rotterdam / NL), Louis de Jong (Rotterdam / NL), Michael H.J. Verhofstad (Rotterdam / NL), Gert Roukema (Rotterdam / NL), Eveline de Haan (Rotterdam / NL)
Abstract text (incl. references and figure legends)
INTRODUCTION
Factors associated with high mortality rates in geriatric hip fracture patients are frequently non-modifiable. Time to surgery however might be a modifiable factor of interest to optimize clinical outcomes after hip fracture surgery. This study aims to determine the influence of postponement of surgery due to non-medical reasons on clinical outcomes in acute hip fracture surgery.
METHODS
This observational cohort study enrolled consecutively admitted patients with a proximal femur fracture for which surgery was performed between 1 January 2018 and 11 January 2021 in two level II trauma teaching hospitals. Patients with medical indications to postpone surgery were excluded.
RESULTS
A total of 1,803 patients were included, of which 1,428 patients had surgery < 24 hours and 375 had surgery ≥ 24 hours after admission. Prolonged total length of stay was found when surgery was performed ≥ 24 hours (6 (4 – 9) days versus 7 (5 – 10) days, p = 0.001). No differences in postoperative length of hospital stay nor in 30-day mortality rates were found. In subgroup analysis for time frames of each 12 hours, decubital ulcers and urinary tract infections were diagnosed more frequently when time to surgery increased.
CONCLUSION
Longer time to surgery due to non-medical reasons was associated with a higher percentage of postoperative decubital ulcers and urinary tract infections when time to surgery was more than 48 hours. No association was found between time to surgery and 30-day mortality rates or postoperative length of hospital stay.
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