Relationship of preoperative surgical delay to mortality after hip fracture in elderly patients

ABSTRACT

To determine whether a delay in surgery for hip fractures affects postoperative mortality among elderly patients. Descriptive case-series Orthopedic department KGMC/PGMI Hayatabad Medical complex Peshawar, from January 2010 to December 2010. This is a retrospective study of 160 patients who underwent surgical treatment of a hip fracture. Postoperative mortality rates were measured in relation to the delay in the surgery and the acute medical comorbidities on admission. Total mortality following the hip fracture surgery was 16.3%, [in-hospital 5.6% and 30-days 10.6%]. When compared pre-operative delay in patients who had surgery within 2 days, those who were operated within 2-4 days and those who waited >4 days, the mortality rates were 1.3%, 5.6% and 9.4% respectively [with significant p value of 0.042]. In patients with acute medical comorbidities, the 30-days mortality was 2.5% in those operated between 2-4 days and 3.7% in those where surgery had been delayed >4 days [insignificant p value 0.56]. Patients with acute medical comorbidities that required treatment prior to the surgery had 1.6 times risk of death in 30-days as compared to those patients who had been initially considered fit for surgery. Mortality was increased when surgery was delayed for more than 2 days for patients who were otherwise fit for hip fracture surgery