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SummaryObjectiveTo provide a comprehensive transnational overview of wait times for epilepsy surgery in Canada and Mexico.MethodsWe reviewed all cases referred for epilepsy surgery between 2007 and 2015 at the Saskatchewan Epilepsy Program Royal University Hospital (SEP) (n = 70; Saskatoon, Canada) and the National Institute of Neurology and Neurosurgery (NINN) (n = 76; Mexico City, Mexico) and compared wait times, calculated as the time from diagnosis of epilepsy on assessment at an epilepsy center to epilepsy surgery.ResultsMean wait times were similar across centers. Mean patient age was 37.4 ± 9 years (NINN) and 36.7 ± 13.2 years (SEP). The mean time from epilepsy diagnosis to referral was 18.9 (NINN) and 16.9 years (SEP), p = 0.30; first consult with the epileptologist, 19.7 (NINN) and 17.4 years (p = 0.23); neuropsychology consult, 21.4 (NINN) and 17.9 years (SEP); video electroencephalogram (video‐EEG) telemetry, 21.1 (NINN) and 18.6 months (SEP); initial neurosurgical consult, 21.9 (NINN) and 19.1 years (SEP) (p = 0.35); and epilepsy surgery, 19.7 (NINN) and 19.6 years (SEP) (p = 0.29).SignificanceThis is the first study to compare wait times between Canada and Mexico. Despite disparity in their health delivery systems and financial resources, surgical wait times appeared to be protracted in both nations, confirming that delayed treatment is a universal problem that requires collaborative scrutiny.

Days alive and at home´is a validated measure that estimates the time spent at home, defined as the place of residence before admission to hospital. We evaluated this metric in older adults after hip fracture surgery and assessed two follow-up durations, 30 and 90 days. Patients aged ≥ 70 years who underwent hip fracture surgery were identified retrospectively via hospital admission and government mortality records. Patients who successfully returned home and were still alive within 90 days of surgery were distinguished from those who were not. Regression models were used to examine which variables were associated with failure to return home and number of days at home among those who did return, within 90 days of surgery. We analysed the records of 825 patients. Median (IQR [range]) number of days at home within 90 days (n = 788) was 54 (0-76 [0-88]) days and within 30 days (n = 797) it was 2 (0-21 [0-28]) days. Out of these, 274 (35%) patients did not return home within 90 days and 374 (47%) within 30 days after surgery. Known peri-operative risk-factors such as older age, pre-operative anaemia and postoperative acute renal impairment were associated with failure to return home. This study supports days alive and at home as a useful patient-centred outcome measure in older adults after hip fracture surgery. We recommend that this metric should be used in clinical trials and measured at 90, rather than 30, postoperative days. As nearly half of this patient population did not return home within 30 days, the shorter time-period catches fewer meaningful events.