Abstract
Early surgical intervention in hip fractures is associated with lower complications. This study aimed to determine the appropriate operation time among Asian geriatric patients. The data of 1118 elderly patients with hip fracture at Mackay Memorial Hospital from 1 January 2011, to 31 July 2019, were retrospectively examined. Association between operation waiting time and the occurrence of complications was calculated using a cubic spline model. Significantly increased incidence of pneumonia, myocardial infarction, and heart failure was observed in 30 and 90 days when the patient’s surgical waiting time exceeded 36 h. The incidence rates of pneumonia across the early and delayed groups within 30 and 90 days were 4.4% vs. 7.9%, and 6.2% vs. 10.7%, those of myocardial infarction were 3.0% vs. 7.2%, and 5.7% vs. 9.3%, and those of heart failure were 15.2% vs. 26.8%, and 16.2% vs. 28.5%. Deep vein thrombosis and pulmonary embolism were not associated with surgical delay. The overall 30-day mortality rate was 5.4%, and no significant difference was observed when the surgical waiting time exceeded 36 h. In summary, operation waiting time exceeding 36-h was associated with increased rates of pneumonia, myocardial infarction, and heart failure in Asian geriatric patients undergoing hip fracture surgery.
Highlights
Hip fracture is a devastating injury with complications that can lead to serious morbidity and mortality
Some studies have investigated the association between operation waiting time and complication risks, and found that early surgical intervention of hip fracture is associated with a lower complication rate [4,5,6,7]
A total of 1118 geriatric patients who suffered from hip fracture were included in this study (Figure 1)
Summary
Hip fracture is a devastating injury with complications that can lead to serious morbidity and mortality. A previous study projected an increased rate of hip fracture in Asian countries of approximately 2.56 million victims in 2050 [1]. Taiwan has been estimated to have the highest incidence rate of hip fracture. Along with the increase of hip fracture incidence in Asian countries, studies have predicted an increase in medical cost and healthcare system burden among Asian countries [1,2,3]. This condition should be considered a top medical priority. Some studies have investigated the association between operation waiting time and complication risks, and found that early surgical intervention of hip fracture is associated with a lower complication rate [4,5,6,7]
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