Evidence map›Paper›PMID 33376809›Full record

ArticleTrauma surgery & acute care open2020

Factors associated with optimal patient outcomes after operative repair of isolated hip fractures in the elderly.

Alirio J deMeireles, Laura Gerhardinger, Bryant W Oliphant, Peter C Jenkins, Anne H Cain-Nielsen, John W Scott, Mark R Hemmila, Naveen F Sangji

Abstract read
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In one paragraph

Article in Trauma surgery & acute care open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Defining a Hip Fracture: Surveying Orthopaedic Surgeons to Better Characterize the Injury.The Journal of the American Academy of Orthopaedic Surgeons · 2026
    Article
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  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alirio J deMeirelesDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-3794-916X
Laura GerhardingerDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Bryant W OliphantDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Peter C JenkinsDepartment of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Anne H Cain-NielsenDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
John W ScottDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-9916-6523
Mark R HemmilaDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Naveen F SangjiDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Funding

Quality Assurance and Quality Control Project Management: Improving Submissions and Study Conduct in the Human Subjects Research Prior Approval ProcessUL1TR002529 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI MOE, SHARON M, WIEHE, SARAH ELIZABETH · 2018 to 2022
$27.2M
NCATS NIH HHS UL1 TR002529
6 · The paper itself

Abstract

backgroundIncreased time to operative intervention is associated with a greater risk of mortality and complications in adults with a hip fracture. This study sought to determine factors associated with timeliness of operation in elderly patients presenting with an isolated hip fracture and the influence of surgical delay on outcomes.

methodsTrauma quality collaborative data (July 2016 to June 2019) were analyzed. Inclusion criteria were patients ≥65 years with an injury mechanism of fall, Abbreviated Injury Scale (AIS) 2005 diagnosis of hip fracture, and AIS extremity ≤3. Exclusion criteria included AIS in other body regions >1 and non-operative management. We examined the association of demographic, hospital, injury presentation, and comorbidity factors on a surgical delay >48 hours and patient outcomes using multivariable regression analysis.

results10 182 patients fit our study criteria out of 212 620 patients. Mean age was 82.7±8.6 years and 68.7% were female. Delay in operation >48 hours occurred in 965 (9.5%) of patients. Factors that significantly increased mortality or discharge to hospice were increased age, male gender, emergency department hypotension, functionally dependent health status (FDHS), advanced directive, liver disease, angina, and congestive heart failure (CHF). Delay >48 hours was associated with increased mortality or discharge to hospice (OR 1.52; 95% CI 1.13 to 2.06; p<0.01). Trauma center verification level, admission service, and hip fracture volume were not associated with mortality or discharge to hospice. Factors associated with operative delay >48 hours were male gender, FDHS, CHF, chronic renal failure, and advanced directive. Admission to the orthopedic surgery service was associated with less incidence of delay >48 hours (OR 0.43; 95% CI 0.29 to 0.64; p<0.001). DISCUSSION: Hospital verification level, admission service, and patient volume did not impact the outcome of mortality/discharge to hospice. Delay to operation >48 hours was associated with increased mortality. The only measured modifiable characteristic that reduced delay to operative intervention was admission to the orthopedic surgery service. LEVEL OF EVIDENCE: III.

Indexed as

health carehip fracturesmortalityoutcome assessmentquality improvement

Identifiers

PMID33376809
PMCPMC7757513

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