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In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study

The early recovery of hip function after hip fracture surgery values more attention, especially for patients with delayed surgery of longer than 48 h. We aim to evaluate the associations of in-hospital surgical waiting time with the functional outcomes [Harris Hip Score (HHS), Parker Mobility Score...

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Autores principales: Cai, Qianying, Fu, Kai, Jia, Weitao, Li, Xiaolin, He, Haiyan, Yao, Zhenjun, Chen, Xiaodong, Dong, Yuqi, Wang, Qiugen, Kang, Bin, Qian, Biyun, Chen, Shengbao, Zhang, Changqing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389213/
https://www.ncbi.nlm.nih.gov/pubmed/37039039
http://dx.doi.org/10.1097/JS9.0000000000000385
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author Cai, Qianying
Fu, Kai
Jia, Weitao
Li, Xiaolin
He, Haiyan
Yao, Zhenjun
Chen, Xiaodong
Dong, Yuqi
Wang, Qiugen
Kang, Bin
Qian, Biyun
Chen, Shengbao
Zhang, Changqing
author_facet Cai, Qianying
Fu, Kai
Jia, Weitao
Li, Xiaolin
He, Haiyan
Yao, Zhenjun
Chen, Xiaodong
Dong, Yuqi
Wang, Qiugen
Kang, Bin
Qian, Biyun
Chen, Shengbao
Zhang, Changqing
author_sort Cai, Qianying
collection PubMed
description The early recovery of hip function after hip fracture surgery values more attention, especially for patients with delayed surgery of longer than 48 h. We aim to evaluate the associations of in-hospital surgical waiting time with the functional outcomes [Harris Hip Score (HHS), Parker Mobility Score (PMS), and EuroQol 5 dimensions VAS (visual analogue scale) score (EQ-5D VAS)] in elderly patients who sustained hip fractures. MATERIALS AND METHODS: Data on sociodemographic and clinical factors were prospectively collected using a multicenter hip fracture registry system. Participants in the cohort underwent a 12-month follow-up investigation. After adjusting potential confounders identified by the directed acyclic graphs, the associations between surgical waiting time longer than 48 h and functional outcomes were estimated by log-binomial regression and multivariable linear regression models with generalized estimating equations. RESULTS: Of 863 survival participants with available functional data at 12 months after surgery, an increased risk was obtained from receiving surgery after 48 h and the poor functional outcomes (HHS<80: relative risk (RR)=1.56, 95% CI: 1.00–2.51; PMS<7: RR=1.49, 95% CI: 1.13–2.01; EQ-5D VAS<80: RR=1.97, 95% CI: 1.57–2.47). In-hospital waiting time greater than 48 h were time-invariantly associated with lower PMS during recovery (−0.44 units 95% CI: −0.70 to −0.18). In addition, delayed surgery was time-varying associated with HHS and EQ-5D VAS. CONCLUSIONS: The associations between in-hospital waiting time and postoperative functional score suggest that delayed surgery can lead to poor functional outcomes, especially in patients waiting longer than 72 h from injury. Delayed surgery mainly impacted hip function and mobility recovery with a slower speed in early recovery of the first 3 months. More attention should be paid to mechanisms behind the associations between delayed surgery on general healthy status.
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spelling pubmed-103892132023-08-01 In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study Cai, Qianying Fu, Kai Jia, Weitao Li, Xiaolin He, Haiyan Yao, Zhenjun Chen, Xiaodong Dong, Yuqi Wang, Qiugen Kang, Bin Qian, Biyun Chen, Shengbao Zhang, Changqing Int J Surg Original Research The early recovery of hip function after hip fracture surgery values more attention, especially for patients with delayed surgery of longer than 48 h. We aim to evaluate the associations of in-hospital surgical waiting time with the functional outcomes [Harris Hip Score (HHS), Parker Mobility Score (PMS), and EuroQol 5 dimensions VAS (visual analogue scale) score (EQ-5D VAS)] in elderly patients who sustained hip fractures. MATERIALS AND METHODS: Data on sociodemographic and clinical factors were prospectively collected using a multicenter hip fracture registry system. Participants in the cohort underwent a 12-month follow-up investigation. After adjusting potential confounders identified by the directed acyclic graphs, the associations between surgical waiting time longer than 48 h and functional outcomes were estimated by log-binomial regression and multivariable linear regression models with generalized estimating equations. RESULTS: Of 863 survival participants with available functional data at 12 months after surgery, an increased risk was obtained from receiving surgery after 48 h and the poor functional outcomes (HHS<80: relative risk (RR)=1.56, 95% CI: 1.00–2.51; PMS<7: RR=1.49, 95% CI: 1.13–2.01; EQ-5D VAS<80: RR=1.97, 95% CI: 1.57–2.47). In-hospital waiting time greater than 48 h were time-invariantly associated with lower PMS during recovery (−0.44 units 95% CI: −0.70 to −0.18). In addition, delayed surgery was time-varying associated with HHS and EQ-5D VAS. CONCLUSIONS: The associations between in-hospital waiting time and postoperative functional score suggest that delayed surgery can lead to poor functional outcomes, especially in patients waiting longer than 72 h from injury. Delayed surgery mainly impacted hip function and mobility recovery with a slower speed in early recovery of the first 3 months. More attention should be paid to mechanisms behind the associations between delayed surgery on general healthy status. Lippincott Williams & Wilkins 2023-04-11 /pmc/articles/PMC10389213/ /pubmed/37039039 http://dx.doi.org/10.1097/JS9.0000000000000385 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Cai, Qianying
Fu, Kai
Jia, Weitao
Li, Xiaolin
He, Haiyan
Yao, Zhenjun
Chen, Xiaodong
Dong, Yuqi
Wang, Qiugen
Kang, Bin
Qian, Biyun
Chen, Shengbao
Zhang, Changqing
In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title_full In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title_fullStr In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title_full_unstemmed In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title_short In-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
title_sort in-hospital waiting time to surgery and functional outcomes in geriatric hip fractures: a directed acyclic graph-based preplanned analysis from a prospective multicenter cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389213/
https://www.ncbi.nlm.nih.gov/pubmed/37039039
http://dx.doi.org/10.1097/JS9.0000000000000385
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