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Archives of Orthopaedic and Trauma Surgery

Published in:

01-06-2004 | Original Article

Morbidity and mortality after hip fracture: the impact of operative delay

Authors: Michael Gdalevich, Dani Cohen, Dina Yosef, Chanan Tauber

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2004

Abstract

Introduction

The relationship between the timing of surgery after hip fracture and the subsequent survival of the patient has been studied extensively, yet still remains a controversy. This study aims to assess the impact of operative delay on the 1-year survival of patients and on the rate of complications during the postoperative hospital stay.

Materials and methods

Medical and demographic data were extracted from the hospital records of 651 consecutive hip fracture patients over 60 years old. Information on mortality was obtained by cross-linkage with the Department of Interior population files. The multivariate survival analysis model was utilized to assess the association between the time from fracture incident to surgery and the outcome (1-year survival and postoperative complications).

Results

The hazard ratio (HR) of 1-year mortality for postponing surgery beyond 48 h was 1.63 (95%CI 1.11–2.40), as derived by the Cox proportional hazards model. Other variables found to be independently associated with decreased survival are: male gender (HR=1.54), mental deterioration (HR=2.94), postoperative mobility (HR=2.45), and severity of pre-existing diseases (HR=1.96). Occurrence of general complications during the postoperative hospital stay was a significant predictor of decreased 1-year survival (HR=1.83).

Conclusion

These findings suggest that early (within 48 h) surgical treatment of hip fractures is associated with improved 1-year survival.

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Title: Morbidity and mortality after hip fracture: the impact of operative delay
Authors: Michael Gdalevich
Dani Cohen
Dina Yosef
Chanan Tauber
Publication date: 01-06-2004
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2004
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-004-0662-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Morbidity and mortality after hip fracture: the impact of operative delay

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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