SynthesisPloS one2012
Timing matters in hip fracture surgery: patients operated within 48 hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients.
Synthesis in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 305 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hip Fracture Epidemiology at Hospital Regional Rafael Hernandez. September 2014 to March 2015.
Impact of Perioperative Nutritional Intervention on Perioperative Outcomes of Elderly Patients Having Hip Fracture Surgery: A Randomized Control Trial
Who cites it
305 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Venous thromboembolism and major adverse cardiovascular events in patients with hip fractures suffering from SARS-CoV-2 infection: a systematic review.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2023Pooled it
- Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures: A Systematic Review.JAMA network open · 2022Pooled it
- Synthesis of the evidence on the impact of pre-operative direct oral anticoagulants on patient health outcomes after hip fracture surgery: rapid systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Waterlow score for risk assessment in surgical patients: a systematic review.Annals of the Royal College of Surgeons of England · 2021Pooled it
- Surgical versus non-surgical management of lateral compression type-1 pelvic fracture in adults 60 years and older: the L1FE RCT.Health technology assessment (Winchester, England) · 2024Trial
- In-hospital mortality in hip fracture patients undergoing surgery later than 24 hours post admission might rather reflect the impact of comorbidities and treatment limitations than additional risks imposed by the mere timely delay itself.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Hip Fracture Management in Older Adults in Resource-Constrained Settings: Determinants, Care Pathways, and Outcomes-A Systematic Review and Meta-Analysis.Health science reports · 2026Review
- [Treatment of proximal femur fractures in patients on direct oral anticoagulants (DOACs) : Review of perioperative management].Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Article
- Waiting time and mortality after hip fracture: findings from a large single-center cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Femoral Arterial Calcification, Atherogenic Index of Plasma, and 1-Year Mortality After Hip Fracture: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Early surgery of trochanteric femoral fractures in patients on direct oral anticoagulants (DOACs) reduces the length of stay (LOS) and the 1-year mortality rates without increasing the risk for revision surgery: a matched-pair analysis.Archives of orthopaedic and trauma surgery · 2026Article
- Establishing Independent Predictors of Early Geriatric Hip Fracture Surgery.Hip & pelvis · 2026Article
- Gender Influences Patient Characteristics, Fracture Pattern, Achievement of Clinical Care Targets and Postoperative Mortality Risk Following a Hip Fracture: A Retrospective Cohort Study.Musculoskeletal care · 2026Article
- Time to surgery and its impact on length of stay and mortality for neck of femur fractures at a major trauma centre.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Preoperative stay under 48 h after admission for proximal femur fractures is linked to fewer complications and better outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- The Surgical Timing Gap in Elderly Hip Fracture Management: A Regional Systems Analysis.Cureus · 2026Article
- Article
- Patient-related rather than surgery-related factors predict mortality following femoral stem revision for periprosthetic femoral fracture: a series of three hundred and ninety eight cases.International orthopaedics · 2026Article
245 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundTo assess the relationship between surgical delay and mortality in elderly patients with hip fracture. Systematic review and meta-analysis of retrospective and prospective studies published from 1948 to 2011. Medline (from 1948), Embase (from 1974) and CINAHL (from 1982), and the Cochrane Library. Odds ratios (OR) and 95% confidence intervals for each study were extracted and pooled with a random effects model. Heterogeneity, publication bias, bayesian analysis, and meta-regression analyses were done. Criteria for inclusion were retro- and prospective elderly population studies, patients with operated hip fractures, indication of timing of surgery and survival status. METHODOLOGY/PRINCIPAL
findingsThere were 35 independent studies, with 191,873 participants and 34,448 deaths. The majority considered a cut-off between 24 and 48 hours. Early hip surgery was associated with a lower risk of death (pooled odds ratio (OR) 0.74, 95% confidence interval (CI) 0.67 to 0.81; P<0.000) and pressure sores (0.48, 95% CI 0.38 to 0.60; P<0.000). Meta-analysis of the adjusted prospective studies gave similar results. The bayesian probability predicted that about 20% of future studies might find that early surgery is not beneficial for decreasing mortality. None of the confounders (e.g. age, sex, data source, baseline risk, cut-off points, study location, quality and year) explained the differences between studies. CONCLUSIONS/SIGNIFICANCE: Surgical delay is associated with a significant increase in the risk of death and pressure sores. Conservative timing strategies should be avoided. Orthopaedic surgery services should ensure the majority of patients are operated within one or two days.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.