Morbidity and mortality after delayed surgical treatment of intertrochanteric hip fractures
DOI:
https://doi.org/10.1016/j.rccot.2017.07.005Keywords:
mortality, morbidity, intertrochanteric hip fractures, surgical delay, hospital stayAbstract
Background: The global trend is to perform early surgery in the treatment of hip fractures, with the objective of reducing mortality and post-surgery complications. As the global consensus is based on evidence of moderate and low quality, the results are not conclusive. The aim of this study is to evaluate whether there are differences in mortality and postoperative hospital stay in operated patients before and after 48 hours of hospital admission.
Materials and methods: Retrospective study was conducted on patients admitted to a trauma centre with a diagnosis of intertrochanteric fracture between 2007 and 2013. Data was extracted from clinical records and using telephone surveys. A survival analysis at 6 and 12 months was performed using the Kaplan Meier test and Log-Rank-test. The chi-squared test was used to compare the mortality percentages and the Student t test used to compare means between groups.
Results: Mortality at 6 months in the early surgery group was 2.9%, and 15.1% (p = .02) in the late surgery group. Hospital stay decreased by 5 days in patients operated before 48 hours (p = .008). There was no statistically significant difference in mortality at one year between the compared groups.
Discussion: The study showed a lower percentage of post-surgical mortality at 6 months, and a decrease in the post-surgical hospital stay in the early surgery group. According to literature, early surgery has the greatest impact on mortality during the first 6 months after the intervention.
Evidence level. III.
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