Influence of Timing of Surgery on Surgical Outcomes of Elderly Hip Fractures

Abstract

Objective: To determine the effect of timing of surgery on surgical outcomes of hip fractures in elderly patients.

Methods: This Cross Sectional study including 150 elderly patients who presented in Indus RTEH campus Muzaffargarh and underwent surgical management for hip fractures was conducted from 1^st  January-2021 to 30^th Dec-2022. The patients were labeled to have early surgery if they underwent surgery within 24 hours of surgery and delayed surgery if they underwent surgery after 24 hours of fracture. Details regarding surgical procedure, duration of surgery and intraoperative blood loss was determined for each patient. The patients were followed for 30 days after surgery. Occurrence of pressure sores, cardiovascular events, implant complications was determined. 30-day operative mortality was also noted.

Results: Mean age of patients was 72.8±7.9 years in early and 74.3±8.2 years in delayed group. Majority patients were females with frequency of 70.6% (53) in early and 76% (57) in delayed group (p-value 0.67). Bed sores occurred in 1 (1.3%) patient in early group and in 5 (6.7%) patients in delayed group with p-value 0.09. UTI occurred in 4 (5.3%) patients in early group versus in 9 (12.0%) patients in delayed group (p-value 0.14). Length of stay was significantly prolonged in delayed group; 7.5±2.3 days versus 6.1±1.8 days in early group, p-value 0.001. 30 days mortality rate was 7 (9.3%) in early group versus 9 (12.0%) in delayed group, p-value 0.59.

Conclusion: Early surgical intervention in elderly patients with hip fractures is beneficial as it significantly lower the risk of post-operative complications and results in early discharge of patient from the hospital.