MORTALITY, POST-OPERATIVE MORBIDITY AND LENGTH OF STAY AFTER HIP FRACTURE: IS DELAY TO SURGERY IMPORTANT?

Objectives To determine whether a delay to surgery (>36Hours) affects mortality rate, length of stay and post-operative complications following hip fracture surgery. Methods Data collected by dedicated Audit staff using a proforma designed in accordance with the ‘Standardised Audit of Hip Fractures in Europe’ (SAHFE). A prospective Observational Study, all patients (n=7207) admitted and who underwent surgery during a 10-year period from May 1999 to May 2009 have been considered. Chi square tests and independent sample t tests were used for basic statistical analyses. Mortality data were analysed using Kaplan Meier survival analysis and cox regression analysis. p Results The 30-day mortality was 9.5%. At 90 days, mortality was 18.9% and at 1 year it was 31.4%. In patients declared fit for surgery on admission (n=5665), 30-day mortality was 7.5% in those operated on without delay, rising to 10.3% at over 4 days delay (p=0.117). However, in those operated on after 5 days delay, 30-day mortality equalled 13.6% (p=0.009). Those declared fit for surgery on admission stayed a total 14.5 days if operated within 36 hours, rising to 16 days with over 36 hours delay (p Conclusions The 30-day mortality following hip fracture surgery is 9.5%. Patients admitted without co-morbidities have significantly increased mortality when surgery is delayed by over 5 days. A 36 hour delay to surgery significantly increases length of stay. Urinary tract infection was the only post-operative morbidity to rise with delay to surgery in fit patients.