The effect of hospital type and surgical delay on mortality after surgery for hip fracture.
J Bone Joint Surg Br
; 87(3): 361-6, 2005 Mar.
Article
em En
| MEDLINE
| ID: mdl-15773647
ABSTRACT
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas do Quadril
/
Hospitais Comunitários
/
Hospitais de Ensino
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Bone Joint Surg Br
Ano de publicação:
2005
Tipo de documento:
Article