92.
Is mortality after hip fracture associated with surgical delay or
admission during weekends and public holidays? - A retrospective study
of 38,020 patients
Cecilie Laubjerg Daugaard
Orthopedic department Bispebjerg Hospital
Background:
Hip fractures are associated with high mortality, the cause of
which is not entirely clear. Surgical delay and admission during weekends and
holidays have been the subject of several studies, but there are discrepancies
among study findings.
Purpose / Aim of Study:
In this study, we investigated the effect of surgical
delay, weekends, holidays and time of admission on mortality in hip fracture
patients.
Materials and Methods:
Using data from the Danish National Indicator
Project, we identified 38,020 patients admitted from 2003 to 2010. Logistic
regression analysis was used to study the association of gender, age, weekend-
or holiday-admission, time to surgery and ASA-score with mortality.
Findings / Results:
The risk of death in hospital increased with surgical delay,
(
odds ratio (OR) = 1.32, CI: 1.25-1.39, P<0.0001) per 24 hours delay. There
was a significant change in in- hospital mortality for ASA score (OR per point
added: 2.28, CI: 2.13 – 2.45, P<0.0001), gender (OR for men: 2.23, CI: 2.0 –
2.47,
P<0.0001) and age (OR per 5 years: 1.43, CI: 1.38 – 1.48, P<0.0001).
Patients admitted during weekends or public holidays did not have an
increased mortality rate (weekends: P=0.49, public holidays: P=0.48).
Conclusions:
Minimizing surgical delay is the most important factor in
reducing mortality in hip fracture patients. ASA-score, gender and age are also
significant factors. We found no increase in the mortality rate for admission
during weekend or holiday
