19.05.2021 | Original Article
Two-thousand hip fractures treated within 12 h and > 12–24 h after admission: Are survival and adverse events affected?
Franz Müller, Andreas Proske, Christoph Eckstein, Christian Wulbrand, Bernd Füchtmeier, Matthias Doblinger
European Journal of Trauma and Emergency Surgery
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The effects of immediate operation on hip fracture (HF) are unclear. Therefore, we investigated the influence of time to operation within 12 h vs. > 12–24 h on survival and adverse events.
This retrospective study was based on our database from 2006 to 2019. Patients ≥ 20 years of age with operations for HF were included. A total of 40 characteristics were analyzed for operations within 12 h (group 1) and > 12–24 h (group 2) after admission. The primary endpoint was survival at 1 year after operation. Secondary endpoints were revision surgery for any reason, infection, and serious adverse events.
A total of 1015 patients received operations within 12 h (group 1), and 985 patients received operations > 12–24 h (group 2) after admission. The mean age of the patients was 78.8 ± 12.3 years. Patients in group 1 were younger and had better health status and shorter hospitalizations than those in group 2. However, no differences were found for revision surgery, infection or adverse events. The mortality rates at 30 days, 90 days, 6 months, and 1 year were 6.2, 11.8, 15.9, and 21.0%, respectively. The mortality rate at day 30 was significantly better (p = 0.04) in group 1, but no further differences in survival were observed (hazard ratio 1.071; 95% confidence interval 0.864–1.328; log rank 0.179). A subgroup analysis of geriatric patients ≥ 65 years assessed no differences according the primary and secondary endpoints.
Within the limits of single-center analysis, the patients receiving treatment for HF within 12 h were younger and healthier and had the benefits of shorter hospitalizations and a higher 30-day survival rate than patients treated > 12–24 h after admission. At the endpoint 1 year after operation, no differences were observed in adverse events or survival rates.