Delayed surgery is associated with adverse outcomes in patients with hip fracture undergoing hip arthroplasty.
BMC Musculoskelet Disord
; 24(1): 286, 2023 Apr 13.
Article
em En
| MEDLINE
| ID: mdl-37055830
ABSTRACT
BACKGROUND:
Hip arthroplasty (HA) is one of the most effective procedures for patients with hip fractures. The timing of surgery played a significant role in the short-term outcome for these patients, but conflicting evidence has been found.METHODS:
The Nationwide Inpatient Sample database was investigated from 2002 to 2014 and identified 247,377 patients with hip fractures undergoing HA. The sample was stratified into ultra-early (0 day), early (1-2 days) and delayed (3-14 days) groups based on time to surgery. Yearly trends, postoperative surgical and medical complications, postoperative length of hospital stay (POS) and total costs were compared after propensity scores were matched between groups by demographics and comorbidity.RESULTS:
From 2002 to 2014, the percentage of hip fracture patients who underwent HA increased from 30.61 to 31.98%. Early surgery groups showed fewer medical complications but higher surgical complications. However, specific complication evaluation showed both ultra-early and early groups decreased most of the surgery and medical complications with increasing post hemorrhagic anemia and fever. Medical complications were also reduced in the ultra-early group, but surgical complications increased. Early surgery groups reduced the POS by 0.90 to 1.05 days and total hospital charges by 32.6 to 44.9 percent than delayed surgery groups. Ultra-early surgery showed no benefit from POS than early group, but reduced total hospital charges by 12.2 percent.CONCLUSION:
HA surgery performed within 2 days showed more beneficial effects on adverse events than delayed surgery. But surgeons should be cognizant of the potential increased risks of mechanical complications and post-hemorrhagic anemia.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artroplastia de Quadril
/
Fraturas do Quadril
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
BMC Musculoskelet Disord
Assunto da revista:
FISIOLOGIA
/
ORTOPEDIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China