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Delayed surgery in hip fracture patients. Can we afford it?
Author(s) -
AlonsoFernández Patricia,
Romero Elena,
Chung Monica,
GarcíaSalmones Marta,
Cabezas Pilar,
Mora Jesús
Publication year - 2016
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2353
Subject(s) - medicine , observational study , hip fracture , orthopedic surgery , barthel index , surgery , physical therapy , activities of daily living , osteoporosis
Abstract The aim is to analyze whether time to surgery (TtoS) in hip fracture patients is associated with longer than expected length of stay (LofS) and whether there is any particular group in which this is especially relevant. We developed an observational study in Madrid, Spain. From 771 patients admitted to the orthopedic ward, we selected 723 with surgical delay ≤7 days. Age was characterized as younger (<81), elderly (81–90), very elderly (>90). Modified Barthel Index was classified as very dependent (<41), moderately dependent (41–80), independent (>80). Results: Median (IQR) TtoS was 3 (1–4) days; LofS 12 (7–15). Mean age was 84.3 years, 78.4% were women. TtoS was associated with LofS, which increased by 1.80 days (95% CI, 1.50–2.10) per delayed day (p<0.001). After adjustment for age, sex, functional status, we found an increase of 1.75 days (1.46–2.04) per day (p<0.001). We did not find effect of age or sex. Functional status had a higher effect in moderately dependent patients 2.25 days (1.78–2.72) than in very dependent or independent patients, 1.33 (0.37–2.30) and 1.50 days (1.09–1.91) respectively (p 0.012). As conclusion we could affirm that increasing TtoS leads to longer than expected LofS in hip fracture patients, particularly moderately dependent patients. Copyright © 2016 John Wiley & Sons, Ltd.