Is 48 h a critical cut-off point for mortality in geriatric hip fractures?

Authors: AHMET EMRE PAKSOY, KERİM ÖNER, FERDİ POLAT, SERHAT DURUSOY

Abstract: Background/aim: In this study, our objective was to evaluate the mortality in geriatric hip fracture patients who were operated within 48 h after admission or after the 48th h. Materials and methods: A total of 194 patients who had undergone surgery for hip fracture between 2016 and 2018 were retrospectively evaluated. Patient information was obtained from the hospital?s database using the ICD codes 81.52, 82.00?82.09, and 82.10. Radiological examination reports were collected from the patient files. Information on mortality was obtained from the Death Notification System of the Turkish Ministry of Health. First-year mortality rates of patients operated within 48 h (Group 1) and those operated at 48?96 h (Group 2) were compared. Results: The mean duration between admission to the hospital and surgical intervention was 33.90 ± 1.95 h (3?96 h). The mean total hospitalization time was 7.29 ± 1.53 days (2?36 days). Of the patients, 62 (32%) died within one year after the operation. The mean survival times for patients operated ?48 h or >48 h were 8.47 ± 1.90 and 6.57 ± 2.59 months, respectively (Z = 1.074, P = 0.283). There was no significant correlation between survival time and the time delay before the operation (r = ?0.103, P = 0.153). Additionally, the Cox regression analysis, including age (years), ASA (grade 3 vs. 2), time to operation (h), and days spent in the ICU, demonstrated no significant independent effect of the time to operation on survival (P = 0.200). Conclusion: Although shortening the time to surgery may have some rationale, we did not find any difference in patients operated before 48 h compared to 48?96 h concerning mortality.

Keywords: Hip fractures, time factors, response time, orthopedic surgery, mortality

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