Operative delay and mortality in elderly patients with hip fracture: an observational study.

Abstract

Hip fracture is the third cause of death among the elderly and appears to be increasingly frequent. We analysed the influence of the major variables in hip fracture management in relation to 30-day mortality. The records of all patients with isolated hip fracture treated at a regional trauma centre from January 1995 to September 2008 were reviewed. Data on demographics, comorbidities, operative delay, complications, functional status at discharge and mortality were collected and subjected to univariate and multivariate analysis. The cohort included 1,199 patients; the mortality rate was 11.7%. Surgery was performed within 48 h of injury in 17.7% and after more than 48 h in 82.3%; the mortality rate was 9.27% in the former and 10.4% in the latter patients; however, at variance with previous reports, operative delay was not associated with a worse outcome in patients with comorbidities. Our data support the policy envisaging fracture repair within 48 h in stable patients and delayed surgery (>48 h) in those with comorbidity conditions requiring stabilization.