Effect of surgical delay on early mortality in patients with femoral neck fracture

The aim of this study was to investigate the relationship between the delay between surgical treatment and mortality occurring within 30 days post-injury in patients aged 60 or older with femoral neck fracture. Data derive from the nationwide database of the National Health Insurance Fund Administration. Logistic regression analysis was performed to analyse the relationship between 30-day mortality and surgical delay in four groups of patients operated on within 12 h, between 12–24 h, 24–48 h or over 48 h post-injury. There were 3,777 patients involved in the study. Mortality rates in the four groups were 7.7%, 10.5%, 10.5% and 9.4%, respectively. Univariate logistic regression analysis revealed a statistically significant increase in the mortality risk in the 12–24-h treatment group compared to the group treated within 12 h (odds ratio, OR_12–24h = 1.413, confidence interval, CI_12–24h: 1.032–1.935; p = 0.031). According to multiple regression analysis, all three groups (12–24 h, 24–48 h and over 48 h) showed a trend to increased mortality risks, but this was not statistically significant (OR_12–24h = 1.301, CI_12–24h: 0.945–1.791, p = 0.106; OR_24–48h = 1.384, CI_24–48h: 0.932–2.056, p = 0.108; OR_>48h = 1.246, CI_>48h: 0.950–1.635, p = 0.113). We can conclude that sex, age and accompanying diseases significantly influenced early mortality, while early post-operative complications did not have a significant impact on the mortality risks.