Anesthesia Experts

The influence of time to surgery on mortality after a hip fracture

by Leave a Comment

The effect of time‐to‐surgery on mortality in acute hip fracture (AHF) patients has been debated and studies are inconsistent regarding from what time‐limit mortality starts to increase. At Sahlgrenska University Hospital/Mölndal, surgery is recommended within 24 hours leaving little time for preoperative optimisation. However, internationally the definition of early surgery varies between 24 to 48 hours and over. This retrospective study was initiated to investigate the relation between time‐to‐surgery and 30‐day mortality.

Method

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.

Results

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.

Conclusion

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.

Leave a Reply

Call (660) 596-2224
What people thought about us

Testimonials

“As Director of Surgical Services Departments there has been considerable changes have occurred in my department and Anesthesia Experts has always risen to meet our demands of our facility. They have been very pro-active in meeting the increase volumes allowing us to keep our surgeons and patients very satisfied with our services.”

AR BSN 346 beds AL   

“Before AE took over the anesthesia department was described by the surgeons as the worst in the history of our hospital. The prior management company was having a cancelled surgery per day. I am happy to report there has not been one since they have taken over the department. Additionally we have seen a 905 reduction if requested preop
lab tests. The anesthesia department is now the very best hospital department in our entire facility.”

DS CEO 272 beds MS   

“Anesthesia Experts has provided consistent anesthesia providers who display a high degree of integrity, responsibility and professionalism. They have become a more valuable part of our facility and community.”

LR CEO 150 beds TX   

“Even though they are physically located 1000 miles away Anesthesia Experts just does not provide great anesthesia coverage they personally engage surgeons to increase their business. Last year my surgical volume rose by 24% and we are currently 50% ahead of last year and all of that growth is organic.”

JE FACHE CEO AL 92 bed hospital   

“Anesthesia Experts is more responsive than anyone I have dealt with. They are available by phone whenever needed and will be on site for any need or request and has been on site to address issues before we can make the request.”

SW CEO 25 beds NM   

“While problems are extremely rare when they do occur Anesthesia Experts quickly and professionally implements a solution. Our surgical volume has grown over 100 cases per month and now our GI docs want to perform all of their endoscopies in our hospital instead of their GI lab that they own!”

SP CEO 346 beds AL   

“Our anesthesia department was a thorn in my side that kept me awake at night. Anesthesia Experts swept in and brought order to our mess and our department was quickly redirected.”

JAM CNO AL 89 bed hospital   

Add a Testimonial

Verification Captcha