Operative Fixation of Hip Fractures in Nonagenarians: Is it Safe?

Structured Abstract Background With the shift in hip fracture epidemiology towards older individuals as well as the shift in demographics towards nonagenarians, it is important to understand the outcomes of treatment for these patients. Methods Geriatric patients (≥65 years old) who underwent surgery for hip fracture were identified in the 2005-2017 National Surgical Quality Improvement Program (NSQIP) database and stratified into two age groups: Results This study included 51,327 0.05). In fact, increased time to surgery in nonagenarians was associated with lower risk of 30-day mortality ([RR]= 0.90, p=0.048). Conclusion Overall complication risk after hip fracture fixation in nonagenarians remains relatively low but higher than their younger counterparts. Interestingly, since time to surgery was not associated with adverse outcomes in nonagenarians, the commonly accepted 48-hour operative window may not be critical to this population. Additional time for preoperative medical optimization in this vulnerable population appears prudent.