ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
The effect of time to surgery on clinical outcomes and hospitalization costs in older adults with femoral shaft fractures: A nationwide retrospective cohort study in Japan.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Optimizing discharge planning: predictors of prolonged hospital length of stay after isolated femoral shaft fracture fixation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
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5 authors.
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Abstract
purposeThis study aimed to evaluate the effect of early surgery on clinical outcomes and hospitalization costs in older adults with femoral shaft fractures.
methodsWe conducted a retrospective cohort study using a nationwide administrative database in Japan, including patients aged 65 years and over who underwent surgery for femoral shaft fractures between 2014 and 2023. Early surgery was defined as surgery performed on the day of admission or the day after admission. We applied inverse probability of treatment weighting (IPTW) using propensity scores to adjust for confounding. Multiple imputation by chained equations was performed to impute missing data. The primary outcome was in-hospital mortality; secondary outcomes included complications, length of postoperative hospital stay, and hospitalization costs.
resultsAmong 11,087 eligible patients, 3,170 (28.6%) received early surgery. After IPTW adjustment, there was no significant difference in in-hospital mortality (odds ratio (OR), 0.96; 95% confidence interval (CI), 0.66-1.41). However, early surgery was associated with significantly lower odds of pneumonia (OR, 0.64; 95% CI, 0.44-0.94) and urinary tract infection (OR, 0.66; 95% CI, 0.48-0.90), shorter postoperative hospital stay (mean difference, 5.37 days; 95% CI, 3.56-7.19), and reduced hospitalization costs (mean difference, 150,380 Japanese yen; 95% CI, 93,270-207,490).
conclusionEarly surgery for femoral shaft fractures in older adults was not associated with a significant reduction in in-hospital mortality compared to delayed surgery. However, it was associated with fewer complications, shorter postoperative hospital stays, and reduced hospitalization costs. These findings suggest that early surgery may be beneficial for improving postoperative recovery.
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