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Delay in Hip Fracture Surgery Prolongs Post-Operative Hospital Length of Stay but Does Not Adversely Affect Outcomes

Mitchell, Sean M., MD1; Chung, Andrew S., DO1; Walker, Joseph B., MD1; Hustedt, Joshua W., MD1; Russell, George V., MD2; Jones, Clifford B., MD1,3

doi: 10.1097/BOT.0000000000001306
Original Article: PDF Only

Objectives: The goal of the present study is to evaluate the association between timing of hip fracture surgery with post-operative length of stay and outcomes.

Design: Retrospective review utilizing the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP) database.

Setting: National inquiry database incorporating 140 academic and private medical centers

Patients: 17,459 patients who underwent surgery for a hip fracture between 2006-2013 were identified from the NSQIP database.

Intervention: Surgical management of hip fractures was performed at the discretion of participating surgeons.

Outcome Measure: 30-day outcomes including post-operative length of stay, readmission rates, reoperation rates, complications, and mortality rates.

Results: Of the 17,459 patients, 4,107 (23.5%) were operated on within 24 hours, 8,740 (50.1%) within 24-48 hours, and 4,612 (26.4%) greater than 48 hours after hospital admission. Increased time to surgery was associated with longer post-operative hospital length of stay. Prolonged time to surgery did not adversely affect post-operative outcomes.

Conclusions: While a delay in the management of hip fractures is associated with an increase in post-operative hospital length of stay, 30-day post-operative outcomes are not adversely affected in patients undergoing hip fracture fixation.

Level of Evidence: 3 (Prognostic retrospective cohort study)

1The University of Arizona, Department of Orthopaedic Surgery, Phoenix, Arizona.

2University of Mississippi Medical Center, Jackson, Mississippi

3The CORE Institute, Phoenix, Arizona

Corresponding Author: Sean M. Mitchell MD, The University of Arizona College of Medicine Phoenix, Department of Orthopaedic Surgery, 1320 N 10th Street, Suit A, Phoenix, AZ 85006, Fax: 01 (602) 839-3671 Telephone: 01 (630) 696-2195 Email: smmitche5@gmail.com

Conflicts of Interest and Source of Funding: CBJ receives IP royalties from Lippincott. GVR is a paid speaker AONA, receives research funding from METRC & Synthes, and holds stock in SMV & Zimmer. SMM, ASC, JBW, and JWH have none to declare.

Presented as a poster at the Orthopaedic Trauma Association Annual Meeting of 2018, October 11-14, Vancouver, Canada

Presented as an e-poster at the International Geriatric Fracture Society Annual Meeting of 2017, October 11, Vancouver, Canada

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