ArticleJournal of clinical orthopaedics and trauma2020
A three-year retrospective multi-center study on time to surgery and mortality for isolated geriatric hip fractures.
Article in Journal of clinical orthopaedics and trauma, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality in COVID-19 patients after proximal femur fracture surgery: a systematic review and meta-analysis.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2023Pooled it
- In-hospital outcome after trochanteric femur fractures is related to preoperative delay but not to the time of day of the procedure: a nationwide retrospective cohort study of 7184 patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Are Tip-Apex Distance and Surgical Delay Associated with Increased Risk of Complications and Mortality Within the First Two Years After Surgery for Femoral Neck Fractures?Journal of clinical medicine · 2025Article
- The Impact of Implementation of Palliative, Non-Operative Management on Mortality of Operatively Treated Geriatric Hip Fracture Patients: A Retrospective Cohort Study.Journal of clinical medicine · 2024Article
- Rate of Complications after Hip Fractures Caused by Prolonged Time-to-Surgery Depends on the Patient's Individual Type of Fracture and Its Treatment.Journal of personalized medicine · 2023Article
- Propensity matched analysis examining the effect of passive reversal of direct oral anticoagulants on blood loss and the need for transfusions among traumatic geriatric hip fractures.European journal of medical research · 2023Article
- Displaced Geriatric Femoral Neck Fractures: A Retrospective Comparison of Total Hip Arthroplasties Versus Hemiarthroplasty.Geriatric orthopaedic surgery & rehabilitation · 2023Article
- Factors That Influence Time to Operating Room for Geriatric Hip Fractures: A Quality Improvement Initiative.Arthroplasty today · 2022Article
- Does time to surgery for traumatic hip fracture impact the efficacy of fascia iliaca blocks? A brief report.Trauma surgery & acute care open · 2022Article
- Mortality profile after 2 years of hip fractures in elderly patients treated with early surgery.Journal of clinical orthopaedics and trauma · 2021Article
- Partial warfarin reversal prior to hip fracture surgical intervention in geriatric trauma patients effects on blood loss and transfusions.Journal of clinical orthopaedics and trauma · 2021Article
- Is 48 h a critical cut-off point for mortality in geriatric hip fractures?Turkish journal of medical sciences · 2020Article
- Investigating the risk factors that affect mortality after cemented hemiarthroplasty in advanced age patients.Journal of orthopaedicsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are multiple reports on the effect of time to surgery for geriatric hip fractures; it remains unclear if earlier intervention is associated with improved mortality, hospital length of stay (HLOS), or cost.
methodsThis was a multi-center retrospective cohort study. Patients (≥65y.) admitted (1/14-1/16) to six level 1 trauma centers for isolated hip fractures were included. Patients were dichotomized into early (≤24 h of admission) or delayed surgery (>24 h). The primary outcome was mortality using the CDC National Death Index. Secondary outcomes included HLOS, complications, and hospital cost.
resultsThere were 1346 patients, 467 (35%) delayed and 879 (65%) early. The early group had more females (70% vs. 61%, p < 0.001) than the delayed group. The delayed group had a median of 2 comorbidities, whereas the early group had 1, p < 0.001. Mortality and complications were not significantly different between groups. After adjustment, the delayed group had no statistically significant increased risk of dying within one year, OR: 1.1 (95% CI:0.8, 1.5), compared to the early group. The average difference in HLOS was 1.1 days longer for the delayed group, when compared to the early group, p-diff<0.001, after adjustment. The average difference in cost for the delayed group was $2450 ($1550, $3400) more expensive per patient, than the early group, p < 0.001.
conclusionsThe results of this study provide further evidence that surgery within 24 h of admission is not associated with lower odds of death when compared to surgery after 24 h of admission, even after adjustment. However, a significant decrease in cost and HLOS was observed for early surgery. If causally linked, our data are 95% confident that earlier treatment could have saved a maximum of $1,587,800. Early surgery should not be pursued purely for the motivation of reducing hospital costs. LEVEL OF EVIDENCE: Level III.
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.