Hip fracture surgery: Does time of the day matter? A case-controlled study

Rashid, Rizwan; Zubairi, Akbar Jaleel; Slote, M. Umer; Noordin, Shahryar

doi:10.1016/j.ijsu.2013.07.003

Cited by 29 publications

(25 citation statements)

References 9 publications

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“…Nighttime kidney transplantation is not associated with increased risk of surgical complications, and survival is independent of the operative time of day [14]. In hip fracture surgery, apart of operative time of day, postoperative complications and postoperative 30-day mortality are comparable, and when an appropriate surgical team is on duty, there was no significant difference between postoperative morbidity and mortality [15,16]. Regarding colorectal surgery, it seems that nighttime colorectal surgery is an independent risk factor for anastomotic leakage and patients having nighttime urgent and emergent colorectal surgery were more likely to die [17,18].…”

Section: Introductionmentioning

confidence: 96%

Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Fernandes

Carvalho

Rodrigues

et al. 2016

Int J Colorectal Dis

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Background Medical activity performed outside regular work hours may increase risk for patients and professionals. There is few data with respect to urgent colorectal surgery. The aim of this work was to evaluate the impact of daytime versus nighttime surgery on postoperative period of patients with acute colorectal disease. Methods A retrospective study was conducted in a sample of patients with acute colorectal disease who underwent urgent surgery at the General Surgery Unit of Braga Hospital, between January 2005 and March 2013. Patients were stratified by operative time of day into a daytime group (surgery between 8:00 and 20:59) and the nighttime group (21:00-7:59) and compared for clinical and surgical parameters. A questionnaire was distributed to surgeons, covering aspects related to the practice of urgent colorectal surgery and fatigue. Results A total of 330 patients were included, with 214 (64.8 %) in the daytime group and 116 (35.2 %) in the nighttime group. Colorectal cancer was the most frequent pathology. Waiting time (p < 0.001) and total length of hospital stay (p = 0.008) were significantly longer in the daytime group. There were no significant differences with respect to early or late complications. However, 100 % of surgeons reported that they are less proficient during nighttime. Conclusions Among patients with acute colorectal disease subjected to urgent surgery, there was no significant association between nighttime surgery and the presence of postoperative medical and surgical morbidities. Patients who were subjected to daytime surgery had longer length of stay at the hospital.

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Section: Introductionmentioning

confidence: 96%

Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Fernandes

Carvalho

Rodrigues

et al. 2016

Int J Colorectal Dis

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“…Some studies defined complications as medical complications or unplanned return to the operating room, 15,24 whereas others reported only wound infection, urinary tract infection, and deep vein thrombosis. 19 Thus direct comparison with these studies was not possible. Further comparison of blood transfusion rate with previous studies was performed, as it represented the most common complication.…”

Section: Postoperative Complication Ratementioning

confidence: 98%

“…This was supported by a study in 2013 that showed no significant difference in postoperative complication rate or mortality rate after reviewing 220 dynamic hip screw surgeries in terms of their operating time. 19 It concluded that out-of-hours surgery offers the benefit of early fixation and mobilisation, and hence may shorten the length of stay and reduce cost of treatment. 19 Chacko et al 14 also reported similar findings in 171 hip fracture patients with surgical intervention where mortality rate within 1 month and complication rate were comparable between the daytime and night-time groups.…”

Section: Outcomes Of Daytime and Out-of-hours Surgerymentioning

confidence: 99%

“…19 It concluded that out-of-hours surgery offers the benefit of early fixation and mobilisation, and hence may shorten the length of stay and reduce cost of treatment. 19 Chacko et al 14 also reported similar findings in 171 hip fracture patients with surgical intervention where mortality rate within 1 month and complication rate were comparable between the daytime and night-time groups. Switzer et al 20 studied the relationship between surgical time of day and outcome after hip fracture fixation.…”

Section: Outcomes Of Daytime and Out-of-hours Surgerymentioning

confidence: 99%

“…15,19,20,23,24 Nonetheless, different analyses and definitions of complication rate were used in these studies. Some studies defined complications as medical complications or unplanned return to the operating room, 15,24 whereas others reported only wound infection, urinary tract infection, and deep vein thrombosis.…”

Section: Postoperative Complication Ratementioning

confidence: 99%

See 2 more Smart Citations

Surgical outcome of daytime and out-of-hours surgery for elderly patients with hip fracture

Chan¹,

Tang

Chow

2017

Hong Kong Med J

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The consequences of out-of-hours hip fracture surgery: insights from a retrospective nationwide study

Forssten

Ismail

Borg

et al. 2021

Eur J Trauma Emerg Surg

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Purpose The study aimed to investigate the association between out-of-hours surgery and postoperative mortality in hip fracture patients. Furthermore, internal fixation and arthroplasty were compared to determine if a difference could be observed in patients operated with these techniques at different times during the day. Methods All patients above 18 of age years in Sweden who underwent hip fracture surgery between 2008 and 2017 were eligible for inclusion. Pathological fractures, non-operatively managed fractures, or cases whose time of surgery was missing were excluded. The cohort was subdivided into on-hour (08:00–17:00) and out-of-hours surgery (17:00–08:00). Poisson regression with adjustments for confounders was used to evaluate the association between out-of-hours surgery and both 30-day and 90-day postoperative mortality. Results Out-of-hours surgery was associated with a 5% increase in the risk of both 30-day [adj. IRR (95% CI) 1.05 (1.00–1.10), p = 0.040] and 90-day [adj. IRR (95% CI) 1.05 (1.01–1.09), p = 0.005] mortality after hip fracture surgery compared to on-hour surgery. There was no statistically significant association between out-of-hours surgery and postoperative mortality among patients who received an internal fixation. Arthroplasties performed out-of-hours were associated with a 13% increase in 30-day postoperative mortality [adj. IRR (95% CI) 1.13 (1.04–1.23), p = 0.005] and an 8% increase in 90-day postoperative mortality [adj. IRR (95% CI) 1.08 (1.01–1.15), p = 0.022] compared to on-hour surgery. Conclusion Out-of-hours surgical intervention is associated with an increase in both 30- and 90-day postoperative mortality among hip fracture patients who received an arthroplasty, but not among patients who underwent internal fixation.

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Hip fracture surgery: Does time of the day matter? A case-controlled study

Cited by 29 publications

References 9 publications

Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Surgical outcome of daytime and out-of-hours surgery for elderly patients with hip fracture

The consequences of out-of-hours hip fracture surgery: insights from a retrospective nationwide study

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