Clinical studyThe effects of time-to-surgery on mortality and morbidity in patients following hip fracture
Section snippets
Design and sample
We performed a retrospective cohort study using data that had been collected to evaluate the effect of transfusion on mortality and morbidity (15). The sample included consecutive patients with hip fractures who were aged 60 years or older and who underwent surgical repair between 1983 and 1993. Patients were excluded if they had metastatic cancer, trauma resulting in multiple injuries requiring surgery, or declined blood transfusion for religious reasons. For this analysis, we also excluded
Results
Of the 9598 patients who were eligible for the study, we excluded 146 patients because the date of the fracture was missing, 127 because of invalid or missing data about time-to-surgery, and 942 because their fracture occurred either ≥48 hours before admission or following admission to the hospital. The final sample included 8383 patients.
The mean (± SD) age of the cohort was 80.4 ± 8.6 years (range, 60 to 106 years), and almost four fifths were women (Table 1). Most patients were white. Of
Discussion
We evaluated the effect of time-to-surgery on mortality and morbidity in hip fracture patients. In unadjusted analyses, the longer the time-to-surgery, the greater the long-term mortality was observed. However, when we adjusted for demographic characteristics and underlying medical problems, the effect of time-to-surgery was no longer statistically significant, suggesting that time-to-surgery is a marker of comorbidity. We found similar results in the analyses of 30-day mortality and most
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