Mini ReviewOpen Access

Importance of Surgical Delay on Mortality in Patients with Hip Fracture: Mini-Review

Volume 3 - Issue 4

**Tarazona Santabalbina FJ*^1,2 Cuesta Peredó D^1,2 Belenguer Varea A^1,2 De la Camara JM⁴ Sivera S⁵ and Avellana Zaragoza JA^1,2**

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- ¹Department of Geriatric Medicine, Hospital Universitario de la Ribera, Spain
- ²Medical School, Universidad Católica de Valencia San vicente Mártir, Spain
- ³Department of Heath Care Quality, Hospital Universitario de la Ribera, Spain
- ⁴Department for Bibliometrics and Publication, Hospital Universitario de la Ribera, Spain.
- ⁵Department of Anesthesia, Hospital Universitario de la Ribera, Spain.
*Corresponding author:Francisco José Tarazona-Santabalbina, Hospital Universitario de la Ribera, Carretera de Corbera, E46600 Alzira, Valencia, Spain

Received: March 28, 2018; Published: April 11, 2018

DOI: 10.26717/BJSTR.2018.03.000945

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Abstract

Introduction: Osteoporotic hip fractures are important health problems in geriatric patients. The mortality rate can reach 10% during admission in hospital and 30% after 12 months. A meta-analysis of 35 independent studies described greater survival among patients who underwent early surgery. Nevertheless, controversy remains about the acceptable waiting time for surgery. The objective of this study is to describe the new knowledge on the relationship between surgical delay and mortality.

Methods: The present review was carried out by conducting an electronic search in OVID (Medline and Embase) on hip fracture, mortality and surgical delay. The search was limited to publications in the last 5 years and in English and Spanish. A total of 73 articles were obtained, of which 14 were finally selected.

Results: Papers can be grouped into those that fund or not a relationship between surgical delay and mortality. Among the first, different authors described a strong association between mortality and complexity measured by a comorbidities index (Charlson Comorbidity Index or American Society of Anaesthesiologists’ score). On the other hand, more studies have shown a strong association between time to surgery and mortality. A study among 42,230 patients used time as a continuous variable showing that wait time was associated with a greater risk of 30- day mortality and other complications.

Conclusion: Surgical delay is clearly linked to mortality risk in the different cut-points studied. Elderly patients admitted at hospital with hip fracture might be operated in the first 24 hours if the clinical conditions allow the surgery process.