Department of Orthopaedic Surgery, The University of Arizona, Phoenix, AZ.
Department of Orthopaedic Surgery University of Mississippi Medical Center, Jackson, MS.
J Orthop Trauma. 2018 Dec;32(12):629-633. doi: 10.1097/BOT.0000000000001306.
To evaluate the association between the timing of hip fracture surgery with postoperative length of stay and outcomes.
Retrospective review using the American College of Surgeons National Surgical Quality Improvement Program database.
National inquiry database incorporating 140 academic and private medical centers.
Seventeen thousand four hundred fifty-nine patients who underwent surgery for a hip fracture between 2006 and 2013 were identified from the National Surgical Quality Improvement Program database.
Surgical management of hip fractures was performed at the discretion of participating surgeons.
Thirty-day outcomes including postoperative length of stay, readmission rates, reoperation rates, complications, and mortality rates.
Of the 17,459 patients, 4107 (23.5%) were operated on within 24 hours, 8740 (50.1%) within 24-48 hours, and 4612 (26.4%) more than 48 hours after hospital admission. Increased time to surgery was associated with longer postoperative hospital length of stay. Prolonged time to surgery did not adversely affect postoperative outcomes.
Although a delay in the management of hip fractures is associated with an increase in postoperative hospital length of stay, 30-day postoperative outcomes are not adversely affected in patients undergoing hip fracture fixation.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估髋部骨折手术时机与术后住院时间及预后的关系。
回顾性分析，使用美国外科医师学会国家手术质量改进计划数据库。
纳入 140 家学术和私人医疗中心的全国性调查数据库。
从国家手术质量改进计划数据库中确定了 2006 年至 2013 年间接受髋部骨折手术的 17459 例患者。
髋部骨折的手术治疗由参与手术的外科医生决定。
30 天结局包括术后住院时间、再入院率、再次手术率、并发症和死亡率。
在 17459 例患者中，4107 例（23.5%）在入院后 24 小时内手术，8740 例（50.1%）在 24-48 小时内手术，4612 例（26.4%）在入院后超过 48 小时手术。手术时间的延长与术后住院时间的延长有关。手术时间的延长并未对术后结局产生不利影响。
尽管髋部骨折治疗的延迟与术后住院时间的延长有关，但接受髋部骨折固定术的患者在 30 天的术后结局不受影响。
预后 III 级。请参阅作者说明以获取完整的证据水平描述。
