Effects of Delayed Hip Fracture Surgery on Mortality and Morbidity in Elderly Patients.
Summary of "Effects of Delayed Hip Fracture Surgery on Mortality and Morbidity in Elderly Patients."
BACKGROUND:
The effects of delaying hip fracture surgery on mortality and morbidity in elderly patients are not completely understood. QUESTIONS/
PURPOSES:
We examined the effects of delays in surgical treatment of hip fracture on mortality, postoperative complications, length of stay in hospital, and functional recovery, in elderly patients. PATIENTS AND
METHODS:
We studied two groups of patients with hip fractures. The first group was studied retrospectively (n = 109); these patients had been exposed to an average delay in receiving surgical treatment of more than 1 week owing to a fire at our hospital. Patients in the second group (n = 79), which we studied prospectively, were operated on within 48 hours of experiencing the fracture or as soon as their medical condition permitted. Rates of mortality and complications were registered for each group.
RESULTS:
We found a larger number of complications in the group with a delay in surgical treatment (pressure ulcer, urinary infection, deep vein thrombosis, and postoperative length of stay), but there were no differences in mortality or functional recovery at 3 months and 1 year.
CONCLUSIONS:
A 1-week delay in the surgical treatment of elderly patients with hip fractures did not increase the mortality rate or prolong the period of recovery but did increase the incidence of postoperative complications. Our experience suggests elderly patients with hip fractures should be operated on as soon as their medical condition permits. LEVEL OF
EVIDENCE:
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Affiliation
Department of Orthopaedics, University Hospital "Reina Sofia", Menendez Pidal Avenue, 14004, Cordoba, Spain.
Journal Details
This article was published in the following journal.
Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21210312
- DOI: http://dx.doi.org/10.1007/s11999-010-1756-z
Medical and Biotech [MESH] Definitions
Puberty, Delayed
The lack of development of SEXUAL MATURATION in boys and girls at a chronological age that is 2.5 standard deviations above the mean age at onset of PUBERTY in a population. Delayed puberty can be classified by defects in the hypothalamic LHRH pulse generator, the PITUITARY GLAND, or the GONADS. These patients will undergo spontaneous but delayed puberty whereas patients with SEXUAL INFANTILISM will not.
Poult Enteritis Mortality Syndrome
An acute, transmissible, infectious disease associated with high MORTALITY and MORBIDITY in young turkeys (poults). It is characterized by DIARRHEA; ANOREXIA; growth depression, and immune dysfunction. The cause is unknown but astroviruses (AVASTROVIRUS) and coronaviruses (CORONAVIRUS, TURKEY) have been isolated from diseased poults and are thought to cause the enteritis and increased susceptibility to bacterial infections.
Hypertrophy, Right Ventricular
Enlargement of the RIGHT VENTRICLE of the heart. This increase in ventricular mass is often attributed to PULMONARY HYPERTENSION and is a contributor to cardiovascular morbidity and mortality.
Midazolam
A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.
Bone Plates
Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999)
PubMed Articles
Evaluation and treatment of osetoporotic distal radius fracture in the elderly patient.
Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. While treatment guidelines for the acute bony injury have been well documented, treatme...
A population-based analysis of the morbidity and mortality of gallbladder surgery in the elderly.
BACKGROUND: Historically, emergency gallbladder surgery in elderly patients has been associated with high rates of morbidity and mortality. Recent studies have described much lower complication rates...
Prognostic value of cardiac troponins in elderly patients with hip fracture-a systematic review.
Cardiac troponins can be elevated in cardiac ischemic conditions or other diseases such as pulmonary embolism or renal failure, where they may predict outcome. We hypothesized that cardiac troponins o...
Why do hip fracture patients die?.
The mortality rate after a hip fracture is very high. It doubles those of people of the same age without fracture and the excess of mortality remains for years. There are several patient-dependent fac...
Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly.
Hip fracture, a moderate musculoskeletal trauma, is associated with a high postoperative mortality. Most patients are elderly, with comorbid conditions and often with heart disease. The objective of t...
Clinical Trials
Postoperative Blood Transfusion for Frail Elderly With Hip Fracture
Elderly with hip fractures are often fragile and discharged from hospital after few days of hospitalisation. Hip fracture surgery is often associated with blood loss, where the patient is...
Testosterone Therapy After Hip Fracture in Elderly Women
The purpose of this study is to determine the feasibility of testosterone replacement therapy in frail elderly female hip fracture patients who have testosterone deficiency, and to obtain...
Fresh Frozen Plasma in Cardiac Surgery: Descriptive and Prognostic Study
Despite experts’ recommendations, the consumption of Fresh frozen plasma (FFP) is very heterogeneous among French cardiac surgery centers. This probably reflects heterogeneous practices...
Hip Protector for Prevention of Hip Fracture
This study aims to evaluate the efficacy of the investigators PSU hip protector for prevention of fracture in elderly.The eligible patients include those with previous diagnosed as unilate...
Mid-term Survival and Quality of Life of Elderly Patients Undergoing Open Heart Surgery
The purposes of the investigators study is to examine the overall survival and quality of life in elderly patients (> 75 years) undergoing open heart surgery at Hadassah medical center bet...
