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Death Rate Goes Up When Surgery Is Delayed for Hip Fracture

Posted on: 11/30/1999
Does a delay in treatment for hip fracture increase the death rate in older adults? This is the question doctors answer in this report. The answer to this question isn't easy. Most patients who have delays until surgery are sicker. Death may be linked more with their poor health than with the delay in the timing of treatment.

Records were studied for more than 18,000 Medicare patients. All were over age 65 and had a closed hip fracture. (A closed fracture means the broken bone didn't break through the skin.) According to this study, delays are more common for patients who break their hips over the weekend. Patients admitted to the hospital on Saturday, Sunday, or Monday have a delay of 1.22 days. This delay is only 1.13 days for patients who come to the hospital Tuesday through Thursday. A delay of two days or more increases the risk of death by 15 percent in the first 30 days after fracture.

Delay in treatment for hip fracture does increase the risk of death in adults over age 65. The results of this study raise more questions. Should patients have surgery immediately after admission? Should surgeons and operating room staff be kept on standby alert over the weekend? It's not yet clear that the extra cost is worth it. More studies are needed before changing hospital policy.

Kevin J. McGuire, MD, MSCE, et al. The 2004 Marshall Urist Award: Delays until Surgery after Hip Fracture Increases Mortality. In Clinical Orthopaedics and Related Research. November 2004. Vol. 428. Pp. 294-301.

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