• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Is There an Optimal Time-to-Surgery Threshold for Hip Fracture Surgery?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Delaying hip fracture surgery is associated with increased mortality risk
    • Wait time to surgery is used as a quality metric
    • Data on optimal time-to-surgery is limited
  • Pincus et al. (JAMA, 2017) sought to discover if there is an optimal time frame from emergency room to hip fracture repair

METHODS:

  • Population-based, retrospective cohort study
  • Patients: Adults undergoing hip fracture surgery between 2009-2014
  • Main exposure: Wait time to surgery from arrival in the emergency department until surgery (hours)
  • Primary outcome was mortality within 30 days
  • Secondary outcome was a composite of mortality or other medical complications (myocardial infarction, deep vein thrombosis, pulmonary embolism, and pneumonia)

RESULTS:

  • 42,230 patients were included
    • Mean (SD) age, 80.1 years (10.7)
    • 70.5% women
    • Mean time to surgery was 38.8 (28.8) hours
  • Overall, mortality at 30 days was 7.0%
  • Risk of complications increased when wait times were greater than 24 hours, regardless of the specific complication
  • 13,731 patients who received surgery within 24 hours (early) were propensity-score matched to patients who received surgery >24 hours (delayed) to adjust for confounders
    • 30 day mortality was 5.8% in the early group vs 6.5% in the delayed group
      • Absolute risk difference 0.79% (95% CI, 0.23%-1.35%)
    • Composite outcome (mortality + complications) was 10.1% in the early group vs 12.2% in the delayed group
      • Absolute risk difference 2.16% (95% CI, 1.43%-2.89%)
    • Risk of complications increased when wait times were greater than 24 hours, regardless of the specific complication

CONCLUSION:

  • Increased wait time for hip replacement surgery was associated with a greater risk of mortality and other complications
  • The authors suggest that a 24-hour window could serve as a wait time threshold for patients with hip fracture upon arrival to the emergency department

Learn More – Primary Sources:

Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery

image_pdfFavoriteLoadingFavorite

< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

ACP Releases Guidance Update on Osteoporosis Treatment
ARCH Study Results: Does Romosozumab Prevent Fracture in Women with Osteoporosis?
The VERO Trial Results: Teriparatide vs Risedronate for the Treatment of Osteoporosis

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site