Delay in hip fracture surgery and its outcomes. A reflection

OPEN How to cite this article Merchán-Galvis Á, Muñoz DA, Solano F, Velásquez JC. Delay in hip fracture surgery and its outcomes. A reflection. Colombian Journal of Anesthesiology. 2021;49(1):e915. What do we know about this problem? Delay in hip fracture surgery represents an increase in postoperative morbidity and mortality, a deterioration in the quality of life and functionality of the affected elderly. Individual and external factors favor the delay in hip osteosynthesis. What is the contribution of this study? Review the state of the art regarding the delay of the osteosynthesis of the hip fracture and its outcomes. Take a position on the factors that delay this type of surgery in the elderly population. Suggests research alternatives in order to improve outcomes in the elderly population. Hip fracture is one of the major public healthcare problems in elderly patients around the world, mainly because of the risk of falls and osteoporosis which are typical during this stage of life, and may be the cause for up to 36% of deaths among those affected. Its management in principle is surgical and the best results are achieved with patients undergoing surgery during the first 24 to 72 hours after the fracture. Any delays in surgery are mostly associated with decompensated personal pathological factors, delays in perioperative assessment, or in presurgical complementary tests; sometimes, the delays are the result of administrative formalities of the healthcare providers. These determining factors may affect both morbidity and mortality, and contribute to functional decline, disability, and reduced quality of life of these patients. A third party intervention is then necessary to improve the preventable factors that delay the osteosynthesis in these types of fractures, in addition to ensuring education, infrastructure, inputs, skilled human resources, and prompt referral of patients from the first level of care. Investigating this scenario and assessing the quality of life impact on these patients should be a priority.