The effect of hospital type and surgical delay on mortality after surgery for hip fracture.
نویسندگان
چکیده
Death during the first year after hip fracture may be influenced by the type of hospital in which patients are treated as well as the time spent awaiting surgery. We studied 57,315 hip fracture patients who were admitted to hospital in Ontario, Canada. Patients treated in teaching hospitals had a decreased risk of in-hospital mortality (odds ratio (OR) 0.89; 95% confidence interval (CI) 0.83 to 0.97) compared with those treated in urban community institutions. There was a trend toward increased mortality in rural rather than urban community hospitals. In-hospital mortality increased as the surgical delay increased (OR 1.13; 95% CI 1.10 to 1.16) for a one-day delay and higher (OR 1.60; 95% CI 1.42 to 1.80) for delays of more than two days. This relationship was strongest for patients younger than 70 years of age and with no comorbidities but was independent of hospital status. Similar relationships were seen at three months and one year after surgery. This suggests that any delay to surgery for non-medical reasons is detrimental to a patient's outcome.
منابع مشابه
Factors influencing surgical delay after hip fracture in hospitals of Emilia Romagna Region, Italy: a multilevel analysis.
Hip fracture is becoming a major public health concern, with associated mortality and morbidity particularly in the elderly. This study aims to investigate factors (i.e. patient factors and hospital variables) associated with increased risk for delaying surgery after hip fractures, and to assess whether and to what extent timing was associated with mortality risk. All patients aged 65 and over,...
متن کاملIs mortality after hip fracture associated with surgical delay or admission during weekends and public holidays?
BACKGROUND AND PURPOSE Hip fractures are associated with high mortality, but the cause of this is still not entirely clear. We investigated the effect of surgical delay, weekends, holidays, and time of day admission on mortality in hip fracture patients. PATIENTS AND METHODS Using data from the Danish National Indicator Project, we identified 38,020 patients admitted from 2003 to 2010. Logist...
متن کاملEconomic Analysis of Regional Versus General Anesthesia for Hip Fracture Surgery
Background: The economic burden of the treatment of hip fracture would be enormous, especially in countries like Iran with an aging population and limited financial resources. The choice of anesthetic technique for hip fracture surgery is controversial. We conducted this retrospective 4 year study to evaluate the effect of regional versus general anesthesia on the length of hospital stay and th...
متن کاملPredictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay
OBJECTIVE Hip fractures have been associated with increased mortality in the elderly. Several risk factors such as the time between the insult and the surgical repair have been associated with hip fracture mortality. Nevertheless, the risk of delayed surgical repair remains controversial. Few studies have examined this issue in Brazil. The aim of this study was to study the risk factors for dea...
متن کاملQuality effects of operative delay on mortality in hip fracture treatment.
BACKGROUND Most hip fracture patients undergo surgery, but there is conflicting evidence on the relation between the timing of surgery and the outcome of treatment. There is considerable variation in the length of surgical delays between hospitals, possibly reflecting the quality of care. AIM To examine the associations between in-hospital surgical delay and the mortality of hip fracture pati...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Journal of bone and joint surgery. British volume
دوره 87 3 شماره
صفحات -
تاریخ انتشار 2005