Early Hip-Fracture Surgery Improves Patient Outcomes

Surgery within 24 hours of admission improves likelihood of returning to independent living

FRIDAY, July 11 (HealthDay News) -- Hip-fracture patients who undergo surgery within 24 hours after hospital admission are significantly less likely to develop pressure ulcers and endure long hospital stays, and more likely to return to independent living than those who undergo later surgery, according to the results of a study published in the July issue of the Journal of Bone & Joint Surgery.

Amer N. Al-Ani, M.D., of Karolinska University Hospital Huddinge in Stockholm, Sweden, and colleagues conducted a prospective study of 850 patients with a hip fracture who were admitted to a hospital during one year.

The researchers found that patients who received surgery after more than 24 hours, 36 hours or 48 hours had higher incidences of pressure ulcers (odds ratios 2.19, 3.42 and 4.34, respectively). They also found that patients in these three groups had longer median hospital stays (18, 19 and 21 days, respectively, compared to the overall median of 14-15 days). Compared to patients who received surgery within 24 hours, those who received surgery after more than 36 or 48 hours were significantly less likely to return to independent living within four months (ORs, 0.44 and 0.33, respectively).

"The indication for potentially time-consuming preoperative medical investigations of hip-fracture patients has to be balanced against the expected negative effect of the prolonged waiting time," the authors write. "Moreover, the availability of operating rooms and support services needs to be optimized in order to avoid system-related causes of a delay of surgery."

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