After hours surgery for elderly hip fracture patients: How safe is it?
- PDF / 603,326 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 89 Downloads / 180 Views
TRAUMA SURGERY
After hours surgery for elderly hip fracture patients: How safe is it? Quan You Yeo1 · Ernest Beng Kee Kwek2 Received: 14 April 2020 / Accepted: 16 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The recent focus on early surgery for hip fractures to reduce complications and improve morbidity, has led some resource-constrained institutions to perform after hours surgery in a bid to meet these timelines. However, there are concerns about the potential increase in complications and poorer outcomes in after hours surgery. This study aims to evaluate the safety of after hours hip fracture surgery and its related complications. Materials and methods This is a retrospective review of hip fracture patients admitted over a 2-year period to a tertiary centre with an established orthogeriatric co-managed hip fracture care pathway. Patients were divided into two groups based on their operating start time: (1) office hours surgery was defined as surgery conducted between 8 am to 5 pm on weekdays and 8 am to 12 noon on Saturdays; and (2) after hours surgery was defined as surgery conducted between 5 pm to 8 am on weekdays, and between Saturday 12 noon to Monday 8 am, as well as those that were conducted on public holidays. Demographic data, comorbidities, fracture details, operative details and outcome measures (complications, mortality and functional scores) were collated. Results A total of 903 patients were surgically treated for per- and intertrochanteric or femoral neck fractures. 76.7% (n = 693) of the patients underwent operation during office hours while 23.3% (n = 210) of the patients underwent after hours operation. 12.4% (n = 26) of the after hours group underwent surgery within 24 h of admission, compared with 6.8% (n = 47) in the office hours group (p = 0.009). We did not find any significant difference between the two groups in terms of complications, mortality and functional outcomes (p > 0.05). Conclusion In conclusion, our study did not show that after hours surgery increases complication rates in hip fracture surgery and had equivalent functional outcomes. Keywords After hours surgery · Elderly hip fracture
Introduction As the world population ages, the rising number of hip fracture patients places a toll on both the healthcare and socioeconomic systems. It is postulated that by 2050, the incidence of hip fracture worldwide is projected to rise to between 7.3 and 21.3 million [1]. Based on 1997 currency values and the projected incidence, analysts estimated that medical cost could * Quan You Yeo [email protected] 1
Department of Orthopaedic Surgery, Tan Tock Seng Hospital Singapore, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
Department of Orthopaedic Surgery, Woodlands Health Campus, Singapore, Singapore
2
translate to between US $153.5 billion and US $446.3 billion annually by 2050 [2]. There is an urgency to operate on these patients and the reasons are multi-fold. Zuckerman et al. reported doubling of the 1 year mo
Data Loading...
