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Delay to Surgical Treatment in Geriatric Hip Fracture Patients

BACKGROUND: Hip fractures in the geriatric population are frequently encountered. There is increasing focus on minimizing the delay to surgery in these patients. This study was designed to evaluate factors responsible for a delay to surgery in a geriatric hip fracture population and how time to surg...

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Autores principales: Joseph, Elias G., Serotte, Jordan, Haider, Mohammad N., Pavlesen, Sonja, Anders, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588415/
https://www.ncbi.nlm.nih.gov/pubmed/37867607
http://dx.doi.org/10.1177/21514593231204760
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author Joseph, Elias G.
Serotte, Jordan
Haider, Mohammad N.
Pavlesen, Sonja
Anders, Mark
author_facet Joseph, Elias G.
Serotte, Jordan
Haider, Mohammad N.
Pavlesen, Sonja
Anders, Mark
author_sort Joseph, Elias G.
collection PubMed
description BACKGROUND: Hip fractures in the geriatric population are frequently encountered. There is increasing focus on minimizing the delay to surgery in these patients. This study was designed to evaluate factors responsible for a delay to surgery in a geriatric hip fracture population and how time to surgery affects mortality. METHODS: A retrospective cohort of patients sustaining low energy geriatric hip fractures in either an American College of Surgeons (ACS) verified Level 1 trauma center or a local university affiliated community teaching hospital were reviewed. The following variables were evaluated as independent risk factors for delay to surgery: demographic data, surgical details, use of cardiology resources, treatment center, and comorbidities. As a secondary objective, the effect of time to surgery on 1 year mortality was analyzed. RESULTS: 1157 patients met inclusion criteria. The following factors increased the risk of delay to surgery greater than 48 hours: male sex, treatment in a community hospital (versus trauma center), older age, multiple comorbidities (eg, cardiovascular-related conditions or other fractures), cardiology consultation, and an American Society of Anesthesiologists physical status score of 3 or 4. Cardiology consultation was the strongest independent predictor of risk for delay to surgery of >48 hours (odds ratio, 6.68; 95% confidence interval, 4.40 to 10.14; P < .001). The 1-year mortality of patients did not differ when surgical treatment occurred before 48 hours or after 48 hours (Log-rank test P = .109). CONCLUSION: The presence of cardiovascular comorbidities and cardiology consultations can delay surgical treatments for hip fractures in patients greater than 65 years old, but the delay did not influence 1-year all-cause mortality. LEVEL OF EVIDENCE: Level IV.
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spelling pubmed-105884152023-10-21 Delay to Surgical Treatment in Geriatric Hip Fracture Patients Joseph, Elias G. Serotte, Jordan Haider, Mohammad N. Pavlesen, Sonja Anders, Mark Geriatr Orthop Surg Rehabil Fellow Corner BACKGROUND: Hip fractures in the geriatric population are frequently encountered. There is increasing focus on minimizing the delay to surgery in these patients. This study was designed to evaluate factors responsible for a delay to surgery in a geriatric hip fracture population and how time to surgery affects mortality. METHODS: A retrospective cohort of patients sustaining low energy geriatric hip fractures in either an American College of Surgeons (ACS) verified Level 1 trauma center or a local university affiliated community teaching hospital were reviewed. The following variables were evaluated as independent risk factors for delay to surgery: demographic data, surgical details, use of cardiology resources, treatment center, and comorbidities. As a secondary objective, the effect of time to surgery on 1 year mortality was analyzed. RESULTS: 1157 patients met inclusion criteria. The following factors increased the risk of delay to surgery greater than 48 hours: male sex, treatment in a community hospital (versus trauma center), older age, multiple comorbidities (eg, cardiovascular-related conditions or other fractures), cardiology consultation, and an American Society of Anesthesiologists physical status score of 3 or 4. Cardiology consultation was the strongest independent predictor of risk for delay to surgery of >48 hours (odds ratio, 6.68; 95% confidence interval, 4.40 to 10.14; P < .001). The 1-year mortality of patients did not differ when surgical treatment occurred before 48 hours or after 48 hours (Log-rank test P = .109). CONCLUSION: The presence of cardiovascular comorbidities and cardiology consultations can delay surgical treatments for hip fractures in patients greater than 65 years old, but the delay did not influence 1-year all-cause mortality. LEVEL OF EVIDENCE: Level IV. SAGE Publications 2023-10-18 /pmc/articles/PMC10588415/ /pubmed/37867607 http://dx.doi.org/10.1177/21514593231204760 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Fellow Corner
Joseph, Elias G.
Serotte, Jordan
Haider, Mohammad N.
Pavlesen, Sonja
Anders, Mark
Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title_full Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title_fullStr Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title_full_unstemmed Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title_short Delay to Surgical Treatment in Geriatric Hip Fracture Patients
title_sort delay to surgical treatment in geriatric hip fracture patients
topic Fellow Corner
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588415/
https://www.ncbi.nlm.nih.gov/pubmed/37867607
http://dx.doi.org/10.1177/21514593231204760
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