ArticleDer Unfallchirurg2014
[Medial femoral neck fractures: possible reasons for delayed surgery. Part 2: Results of data from external inpatient quality assurance within the framework of secondary data evaluation].
Article in Der Unfallchirurg, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Change in Femoral Offset after Closed Reduction and Dynamic Hip Screw Osteosynthesis Via Lateral Approach in Patients with Medial Femoral Neck Fracture: A Retrospective Analysis.Orthopaedic surgery · 2024Article
- [Development of the inpatient quality of care of surgically treated patients with a proximal femoral fracture in North Rhine-Westphalia : Analysis of 61,249 treatment courses based on data from external inpatient quality assurance].Unfallchirurgie (Heidelberg, Germany) · 2022Article
- Analysis of the effects of a delay of surgery in patients with hip fractures: outcome and causes.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- [Management of pre-existing anticoagulation for timely treatment of proximal femoral fractures].Der Unfallchirurg · 2019Review
- [Reasons for proximal femoral fracture surgery delays : Analysis of the structured dialog in Rheinland-Pfalz].Der Unfallchirurg · 2016Article
- [Hip fracture prosthetics in German trauma surgery. State of the art].Der Unfallchirurg · 2015Article
- Mortality after proximal femur fracture with a delay of surgery of more than 48 h.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2014Article
- [Proximal femoral fractures in the German external quality assurance module 17/1: reasons for delay in surgery].Der Unfallchirurg · 2013Article
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
problemIn Germany a disproportionate number of patients with a femoral neck fracture still experience a delay in surgery. In 2008 delays of more than 48 h after admission occurred for 15.4 % of patients. This leads to increases in surgical and general complications as well as pressure sores.
objectivePossible reasons that lead to delayed operations were investigated in a nationwide study. DATA AND
methodsUsing nationwide data from the German inpatient external quality assurance program from the year 2008 the reasons for performing operations later than 48 h after hospital admission were examined both exploratory and analytically using a multiple logistic regression model considering combined effects.
resultsSurgery was more frequently delayed for patients who were admitted to hospital on Friday or Saturday, patients with a higher American Society of Anesthesiologists (ASA) classification, men, patients with malignant diseases, in the presence of infectious diseases and patients with heart disease. Operations carried out within the first 48 h were more frequent with displaced fractures and in the presence of hypertension or mental illness. The volume per hospital had no consistent effect on the time delay of surgery. During the week no significant differences between the departments were detected. On Friday or Saturday surgery was delayed more often when patients were admitted to a department of general surgery than to a department of trauma surgery or orthopedics.
conclusionsThere are medical and non-medical reasons for delayed surgery of femoral neck fractures. Studies have confirmed that delayed surgery for femoral neck fracture harms the patients. Organizational reasons which prevent an immediate operation, e.g. admission on Friday or Saturday, should therefore be eliminated by improvements in hospital organization and staffing. These can be measures of individual hospitals or of several hospitals in cooperation. The target should be to ensure a comprehensive and timely provision of the highest quality care even at the weekend.
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