ArticleBMC musculoskeletal disorders2026
Delayed hospitalization for patients with hip fragility fracture increases mortality risk one year after surgery: a multicentre cohort study.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo determine whether delay from fracture to hospital admission is associated with 1-year mortality after osteoporotic hip fracture surgery.
methodsIn this multicenter retrospective cohort study, 1,733 patients aged ≥ 50 years who underwent surgery for osteoporotic hip fracture were analyzed. Time from fracture to admission, admission to surgery, and fracture to surgery were recorded. Cox regression was used to estimate adjusted hazard ratios (HRs) for 1-year mortality.
resultsOne-year mortality was 6.66%. Longer delay from fracture to admission was independently associated with higher mortality: each additional day increased risk by 6% (adjusted HR 1.06, 95% CI 1.04–1.08; P < 0.001). Patients admitted more than 1 day after fracture had a 44% higher mortality risk than those admitted within 1 day (HR 1.44, 95% CI 1.22–1.71; P < 0.001). Admission beyond 4 days was associated with a twofold increase in mortality (HR 2.01, 95% CI 1.66–2.43; P < 0.001). Time from admission to surgery was not associated with mortality, whereas longer time from fracture to surgery was (per-day HR 1.03, 95% CI 1.02–1.05; P < 0.001; >7 vs. ≤ 7 days: HR 1.46, 95% CI 1.23–1.73; P < 0.001).
conclusionPrehospital delay is an independent predictor of one-year mortality, with risk escalating sharply beyond 4 days. Prioritizing early admission over in-hospital speed may improve survival. For patients with osteoporotic hip fractures, each day of delay in hospitalization increases one-year mortality risk by 6%. This study identifies delayed admission as a key risk factor, highlighting that optimizing referral pathways to reduce pre-hospital delays may improve survival.
trial registrationNot applicable for this observational study.
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