Neck of femur fractures in the elderly: Does every hour to surgery count?

Morrissey, Natasha; Iliopoulos, Efthymios; Osmani, Ahmad; Newman, Kevin

doi:10.1016/j.injury.2017.03.007

Cited by 49 publications

(39 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We were unable to analyse some factors that might vary with time of day and postoperative mortality, including existing patient morbidity, such as history of acute coronary syndrome, although we used ASA physical status as a surrogate for this and other existing morbidities . We did not know how long patients waited for surgery, which might affect postoperative mortality . We used predetermined clock times to generate three epochs, which coincided with nursing shifts, possibly preventing us from detecting associations of postoperative mortality with other clock times.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Many researchers have tried to identify factors associated with increased mortality after anaesthesia and surgery . Some pre‐operative variables are associated with postoperative in‐hospital mortality, including emergency surgery, age and ASA physical status . The time of day when surgery takes place might also be associated with mortality , as it is for rates of vocational accidents and driving accidents and some medical outcomes .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The association of time of emergency surgery – day, evening or night – with postoperative 30‐day hospital mortality

et al. 2018

View full text Add to dashboard Cite

It is unclear whether the time of day for emergency surgery is associated with postoperative mortality. We assessed this association in 9319 patients who had emergency surgery as their first surgery at the Jewish General Hospital, Montreal, QC, Canada from April 2010 to March 2015. Of the 7362 (80%) patients with complete data, 168 (2.3%) died within 30 postoperative days. There was no significant association of time of day with postoperative mortality, with adjusted OR (95%CI) of 1.61 (0.96-2.72) for night vs. day, p = 0.07; 1.29 (0.78-2.13) for night vs. evening, p = 0.33; and 1.26 (0.89-1.78) for evening vs. day, p = 0.20. Studies of more patients and more factors, with longer follow-up, should be carried out to exclude important associations of time of emergency surgery with postoperative mortality and morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The association of time of emergency surgery – day, evening or night – with postoperative 30‐day hospital mortality

et al. 2018

View full text Add to dashboard Cite

show abstract

“…We acknowledged that our inability to determine the duration of time that the patients waited for surgery was a limitation of our study and agree that this has been shown to impact postoperative mortality .…”

mentioning

confidence: 92%

Time of day and 30‐day mortality after emergency surgery. A reply

et al. 2019

View full text Add to dashboard Cite

We thank Dr Kamal for his interest in our study [1]. We included the following variables in our logistic regression model: age; sex; ASA physical status; emergency category; day of surgery; duration of anaesthesia; and type of surgery.In the paper, we acknowledged that other pre-existing patient morbidities may have varied with the time of surgery and might have affected our results.We acknowledged that our inability to determine the duration of time that the patients waited for surgery was a limitation of our study and agree that this has been shown to impact postoperative mortality [2].We were concerned that surgical or anaesthetic sleep deprivation might have a negative impact on patient care.However, we also considered that fewer hospital personnel might be available overnight, or less familiar with the equipment needed relative to the staffing during the regular working day, also with negative consequences. Our results did not reach statistical significance (p < 0.05), but we consider postoperative mortality, although readily quantifiable, to be an extreme end-point. Further investigation is warranted to determine if there are increased morbidities caused by operating overnight relative to daytime for emergency procedures, hence the conclusion in our paper.

show abstract

“…Pero tampoco puede ser una carrera por llegar antes al quirófano, ya que también se ha demostrado que en pacientes inestables se obtienen mejores resultados ajustando el tratamiento médico para optimizar el estado del paciente antes de realizar una intervención quirúrgica de tal magnitud. Por eso, los expertos y guías coinciden en la necesidad de intervenir en las primeras 48 horas y preferiblemente en las primeras 24 horas tras el ingreso en pacientes clínicamente estables y diferir la cirugía en pacientes no aptos para ser intervenidos precozmente en espera de ser valorados por un médico internista o geriatra (35,36,37).…”

Section: Introductionunclassified