Findings from a new study have prompted its authors to suggest all medically stable older adults with hip fracture undergo surgery on the day of their admission to hospital or the following day.
For the study, published in the Canadian Medical Association Journal, researchers analysed data from the Canadian Institute for Health Information on almost 140,000 patients, aged 65 years or older, who had surgery for a first-time hip fracture at 144 hospitals.
They found cumulative 30-day inhospital mortality was 4.9 per cent among patients who were surgically treated on admission day, increasing to 6.9 per cent for surgery done after day three. The authors projected an additional 11 deaths for every 1,000 hip fracture surgeries if all surgeries in medically stable patients were undertaken after inpatient day three rather than admission day. The proportion of inhospital deaths attributable to surgical delays beyond inpatient day two was estimated at 16.5 per cent.
"Our findings allow us to infer a critical point for the timing of hip fracture repair. We suggest that clinicians, administrators, and policy-makers 'not let the sun set twice' on medically stable older adults before their hip fracture repair," said principal investigator Dr Pierre Guy.