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A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 April;64(2):155-62
Operative treatment of hip fractures in the elderly in the first 12 hours of admission versus delayed surgery: assessment of mortality and length of hospitalization
Radoicic D. 1, Popovic Z. 1, Slavkovic Z. 2
1 Clinic for Orthopaedic Surgery and Traumatology, Military Medical Academy Belgrade, Belgrade, Serbia;
2 Clinic for Anesthesiology and Intensive Care, Military Medical Academy Belgrade, Belgrade, Serbia
Aim: Hip fractures are a major problem for health care systems because of high mortality and often long-term hospitalization. Operative management is the treatment of choice, but the timing of surgery is still disputable. The aim of this paper was to determine the impact of operative treatment of the hip fractures in less than 12 hours of admission on postoperative complications, 30 day and one year mortality after fracture and length of hospital stay in comparison to the delayed procedure.
Methods: Prospective study of 702 patients with hip fracture, who were treated operatively in 24 months period; 224 were operated in less than 12h of admission, 478 patients underwent the operation after an average delay of 3.6 days after admission. Recorded and analyzed data included age, sex, type of fracture, postoperative complications, length of hospitalization, 30 day mortality and one year mortality.
Results: In group of patients operated in less than 12 hours of admission mortality at 30 days was 6,70% one year mortality was 13.8%, in the group of patients treated in the delayed procedure 30 day mortality was 9.41% and one year 19.2%. We noted average 8.9 days of hospital stay in the first group compared to 13.8 days of hospital stay for patients operated in delayed procedure.
Conclusion: Surgical treatment of the hip fractures in the first 12 hours of admission, if adequate selection of patients and thorough preoperative preparation is conducted, can be a credible and viable option. It could positively affect the mortality rate compared to a delayed procedure, and reduce the number of hospitalization days.