Mortality and quality of life after proximal femur fracture—effect of time until surgery and reasons for delay

Muhm, M.; Arend, G.; Ruffing, T.; Winkler, H.

doi:10.1007/s00068-013-0267-5

Cited by 19 publications

(12 citation statements)

References 53 publications

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“…We also conducted sensitivity analyses by adding unadjusted data on mortality from the remaining studies to the meta-analysis, irrespective of their bias risk. Adding the non-adjusted data did not alter the results for long-term mortality (RR 0.74, 95% CI 0.64-0.84, 8,903 patients) 13 , 39 , 43 , 46 , 51 , 57 , 59 , 62 , 65 , 68 (see Fig. 2 ).…”

Section: Resultsmentioning

confidence: 90%

“…Of the 28 included studies, 15 had a low 29 , 46 , 53 , 57 , 62 , 68 or moderate 13 , 31 , 39 , 45 , 47 , 52 , 55 , 64 – 66 risk of bias, and 13 studies were rated high risk of bias 43 , 44 , 48 – 51 , 54 , 56 , 58 – 61 , 63 . Most studies used a cut-off time for surgical delay of 48 or 24 hours; other studies used (additional) cut-offs at 6 hours, 12 hours, 18 hours, 36 hours, and 72 hours.…”

Section: Resultsmentioning

confidence: 99%

“…In most of the studies, anticoagulants were more common in the delayed group and frequently caused surgical delay 13 , 39 , 48 , 51 . However, we did not identify any study reporting on differences between early and delayed surgery in patients with and without anticoagulation treatment.…”

Section: Resultsmentioning

confidence: 99%

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Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Klestil

Röder²,

Stotter

et al. 2018

Sci Rep

290

188

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We aimed to assess the impact of timing of surgery in elderly patients with acute hip fracture on morbidity and mortality. We systematically searched MEDLINE, the Cochrane Library, Embase, PubMed, and trial registries from 01/1997 to 05/2017, as well as reference lists of relevant reviews, archives of orthopaedic conferences, and contacted experts. Eligible studies had to be randomised controlled trials (RCTs) or prospective cohort studies, including patients 60 years or older with acute hip fracture. Two authors independently assessed study eligibility, abstracted data, and critically appraised study quality. We conducted meta-analyses using the generic inverse variance model. We included 28 prospective observational studies reporting data of 31,242 patients. Patients operated on within 48 hours had a 20% lower risk of dying within 12 months (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.66–0.97). No statistical significant different mortality risk was observed when comparing patients operated on within or after 24 hours (RR 0.82, 95% CI 0.67–1.01). Adjusted data demonstrated fewer complications (8% vs. 17%) in patients who had early surgery, and increasing risk for pressure ulcers with increased time of delay in another study. Early hip surgery within 48 hours was associated with lower mortality risk and fewer perioperative complications.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

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Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Klestil

Röder²,

Stotter

et al. 2018

Sci Rep

290

188

View full text Add to dashboard Cite

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“…We selected surgery up to day 1 after admission as early surgery because in most studies, early intervention is defined as surgery performed within 24 h after admission or injury. 13 Next, we analyzed 23 parameters as potential factors that delay surgery or affect postsurgical outcome: age at admission gender, pre-injury residence, pre-injury ambulatory ability, day of admission (admission during weekend/public holiday), fracture site (femoral neck fracture or trochanteric fracture), fracture type (stable or unstable type), results of blood tests and urinalysis at admission, chest radiographic abnormalities, electrocardiographic abnormalities, number of systemic chronic diseases, 23 status of dementia, surgical modality (osteosynthesis or femoral head replacement), status of blood transfusion, postoperative complication (requiring treatment by specialists other than orthopedic surgeon), length of hospital stay, ambulatory ability at discharge, and hospital death ( Table 1).…”

Section: Methodsmentioning

confidence: 97%

Efficacy of early surgery and causes of surgical delay in patients with hip fracture

Hagino¹,

Ochiai²,

Senga³

et al. 2015

Journal of Orthopaedics

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“…Abgesehen von der sozioökonomischen Seite weisen HF erhöhte Mortalitätsraten auf: Die Klinikmortalität liegt zwischen 5,5 und 8,3 %, die 1‑Monat-Mortalität zwischen 5 und 10 %, die 3‑Monate-Mortalität zwischen 10,1 und 14,5 % und die 1‑Jahres-Mortalität zwischen 15 und 23,9 % [ 16 , 17 , 20 ].…”

Section: Introductionunclassified

Einflussfaktoren auf die Mortalität bei Patienten mit hüftgelenknahen Frakturen an einem regionalen Traumazentrum

et al. 2021

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Zusammenfassung Hintergrund Krankenhäuser der Grund- und Regelversorgung bzw. regionale Traumazentren spielen eine essenzielle Rolle in der Versorgung hüftgelenknaher Frakturen. Ziel Die vorliegende Arbeit untersucht den Zusammenhang zwischen patientenbezogenen Parametern und der Klinikmortalität sowie dem Auftreten von Komplikationen bei solchen Frakturen an einem regionalen Traumazentrum. Methoden Im Rahmen einer retrospektiven Studie wurden die Daten von allen Patienten, die über 2 Jahre an einem regionalen Traumazentrum mit einer hüftgelenknahen Fraktur aufgenommen wurden, erfasst. Eingeschlossen wurden nur Patienten älter als 60 Jahre. Die patientenbezogenen Parameter umfassten Alter, Geschlecht, Frakturlokalisation, Methode der operativen Versorgung, Operationszeitpunkt, Dauer der Operation und des stationären Aufenthalts, Bluttransfusion, Komplikationen, Komorbiditäten, Einnahme von Antikoagulanzien und Notwendigkeit einer postoperativen intensivmedizinischen Behandlung. Der Zusammenhang zwischen diesen Parametern und der Klinikmortalität sowie dem Auftreten von Komplikationen wurde untersucht. Ergebnisse Daten von 360 Patienten mit 335 Operationen (w:m 225:110) mit einem Alter von 83 ±8 Jahren wurden erfasst. Die Klinikmortalität lag bei 7,76 % (n = 26) und erhöhte sich bei Alter > 85 Jahren (Odds Ratio [OR] 5,126; 95%-Konfidenzintervall [95 %-KI] 0,665–39,498; p = 0,1167), männlichem Geschlecht (OR 1,85 95%-KI [0,82–4,14]; p = 0,0555), Zeitpunkt der Operation > 24 h (OR 1,896 95%-KI [0,661–5,441]; p = 0,2341), ≥ 3 Vorerkrankungen (OR 10,61 95%-KI [3,681–27,501]; p < 0,0001), Einnahme von Antikoagulanzien (OR 6,19 95%-KI [2,69–14,24]; p < 0,0001) und notwendiger postoperativer intensivmedizinischer Behandlung (OR 5,9 95%-KI [2,56–13,76]; p < 0,0001). Schlussfolgerung In der vorliegenden Studie fanden sich statistisch signifikante Einflüsse der Anzahl der Komorbiditäten, der Einnahme von Antikoagulanzien sowie der intensivmedizinischen Behandlung auf die Klinikmortalität bei Patienten mit hüftgelenknahen Frakturen an einem regionalen Traumazentrum.

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Mortality and quality of life after proximal femur fracture—effect of time until surgery and reasons for delay

Cited by 19 publications

References 53 publications

Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Efficacy of early surgery and causes of surgical delay in patients with hip fracture

Einflussfaktoren auf die Mortalität bei Patienten mit hüftgelenknahen Frakturen an einem regionalen Traumazentrum

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