Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM
Delayed surgery for hip fracture is associated with elevated morbidity and mortality, a JAMA study finds.
Using administrative databases in Ontario, researchers studied 42,000 adults who underwent hip fracture surgery in 72 hospitals. Only a third received early surgery — that is, within 24 hours of arriving in the emergency department. Most of these early-surgery patients were matched to a similar number who had delayed surgery (after 24 hours).
The primary outcome — mortality within 30 days of admission — was higher with delayed surgery (6.5% vs. 5.8% with early surgery). Delayed surgery patients also had slightly higher rates of complications like pulmonary embolism, myocardial infarction, and pneumonia.
Editorialists conclude: “A wait time of 24 hours may represent a threshold defining higher risk. Because two-thirds of patients did not receive surgery within this timeframe, performance improvement is warranted.”