Clinical inquiries. What steps can reduce morbidity and mortality caused by hip fractures?

surgery within 24 hours of hip fracture is a critical step in reducing complications, and may decrease mortality compared with conservative care (strength of recommendation [sor]: B, cohort studies). Give patients heparin at the time of admission to prevent venous thromboembolism (vTe) (sor: a, systematic reviews of rCTs). Anticoagulation should be continued in some form for 10 days or until the patient is fully ambulatory (sor: a). Patients should also get prophylactic antibiotics in the 2 hours before surgery (sor: a, meta-analysis of rCT). reduce the risk of postoperative delirium by avoiding certain medications, minimizing sleep disturbances, and providing adequate analgesia (sor: B, systematic review of cohort studies). Aggressive pain control should also be top of mind—higher pain scores are associated with longer hospital stays, delayed ambulation, and long-term functional impairment (sor: c, extrapolation from a single cohort study).