ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Does early surgery within 48 hours improve clinical outcomes in elderly hip fractures? A matched cohort study of 1776 hip fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Impact of modified ERAS protocol implementation on length of stay and complications in elderly hip fracture patients: a before-and-after study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Delayed hospitalization for patients with hip fragility fracture increases mortality risk one year after surgery: a multicentre cohort study.BMC musculoskeletal disorders · 2026Article
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Authors and funding
4 authors.
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Abstract
purposeThe aim of this study was to determine if a delay to surgery of more than 48 h was associated with poorer functional outcomes and increased 1-year mortality rates for elderly hip fractures.
methodsA retrospective review of surgically treated elderly (≥ 60 years old) hip fracture patients in a single institution was conducted. Patients were divided into 2 groups depending on hours from admission to surgery: Group 1 ( ≤ 48 h) and Group 2 (> 48 h); these groups were 1:1 matched for the initial Modified Barthel's Index (MBI) and Charlson Comorbidity Index (CCI).
results2562 patients were eligible for the study. The cut-point value in a receiver operating curve analysis for 12-month MBI against time to surgery was not robust enough to determine an optimal time for surgery. Group 1 (n = 888) had significantly better MBI scores at 6-months [mean 78.7 (± 19.9) vs. mean 75.5 (± 20.6)] and 1-year [mean 80.4 (± 20.1) vs. mean 76.9 (± 22.3)] (p < 0.001). This difference in MBI scores between the groups did not meet the minimal clinically important difference of 10 points. There was no significant difference in 1-year mortality (3.7% vs. 4.4%) (p = 0.427). Delayed surgery past 48 h significantly increased the risk of post-operative complications. (Urinary tract infection, acute retention of urine and pneumonia) (p < 0.001).
conclusionDelayed surgery for elderly hip fractures after 48 h increases the risk of acute post-operative complications. There is no increase in 1-year mortality and no clinically important deterioration of MBI if operated on after 48 h. LEVEL OF EVIDENCE: III.
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