Department of Orthopaedics, University Hospital Reina Sofia, Menendez Pidal Avenue, 14004 Cordoba, Spain.
Clin Orthop Relat Res. 2011 Nov;469(11):3218-21. doi: 10.1007/s11999-010-1756-z. Epub 2011 Jan 6.
The effects of delaying hip fracture surgery on mortality and morbidity in elderly patients are not completely understood.
QUESTIONS/PURPOSES: We examined the effects of delays in surgical treatment of hip fracture on mortality, postoperative complications, length of stay in hospital, and functional recovery, in elderly patients.
We studied two groups of patients with hip fractures. The first group was studied retrospectively (n = 109); these patients had been exposed to an average delay in receiving surgical treatment of more than 1 week owing to a fire at our hospital. Patients in the second group (n = 79), which we studied prospectively, were operated on within 48 hours of experiencing the fracture or as soon as their medical condition permitted. Rates of mortality and complications were registered for each group.
We found a larger number of complications in the group with a delay in surgical treatment (pressure ulcer, urinary infection, deep vein thrombosis, and postoperative length of stay), but there were no differences in mortality or functional recovery at 3 months and 1 year.
A 1-week delay in the surgical treatment of elderly patients with hip fractures did not increase the mortality rate or prolong the period of recovery but did increase the incidence of postoperative complications. Our experience suggests elderly patients with hip fractures should be operated on as soon as their medical condition permits.
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
老年人髋部骨折手术延迟对死亡率和发病率的影响尚不完全清楚。
问题/目的：我们研究了髋部骨折老年患者手术治疗延迟对死亡率、术后并发症、住院时间和功能恢复的影响。
我们研究了两组髋部骨折患者。第一组为回顾性研究（n=109）；由于我院发生火灾，这些患者平均接受手术治疗的延迟时间超过 1 周。第二组（n=79）前瞻性研究，这些患者在骨折后 48 小时内或在其身体状况允许的情况下进行手术。记录了每组的死亡率和并发症发生率。
我们发现手术治疗延迟组的并发症发生率更高（压疮、尿路感染、深静脉血栓形成和术后住院时间延长），但在 3 个月和 1 年内死亡率或功能恢复方面没有差异。
老年髋部骨折患者手术治疗延迟 1 周不会增加死亡率或延长恢复时间，但会增加术后并发症的发生率。我们的经验表明，髋部骨折的老年患者应在其身体状况允许的情况下尽快进行手术。
III 级，治疗性研究。有关证据水平的完整描述，请参见作者指南。
