Data of AHF‐patients from January 2007 through December 2016 was collected. The variables analysed were: age, gender, ASA physical status classification, surgical method (prosthesis or osteosynthesis), and time‐to‐surgery, along with 30‐day mortality. Primary outcome was 30‐day mortality related to time‐to‐surgery divided into groups. Secondary outcome was 30‐day mortality related to time‐to‐surgery analysed hour‐by‐hour.
From 10,844 eligible patients, 9,270 patients were included into the study. Mean time‐to‐surgery was 19.4 hours and overall 30‐day mortality was 7.6%. Adjusted Cox regression analysis revealed an increased mortality rate in patients with time‐to‐surgery >48h. In the hour‐by‐hour‐analysis, significant mortality increase was observed at 39 hours of time‐to‐surgery. Patients with time‐to‐surgery >24h did not have increased mortality compared to patients with time‐to‐surgery <24h.
In AHF‐patients, a time‐to‐surgery exceeding 39‐48 hours was associated with increased mortality. Patients with surgeries performed before 39‐48 hours did not have increased mortality and this time may, in some patients, be used for optimisation prior surgery even if time‐to‐surgery exceeds 24 hours.