Delay in Hip Fracture Surgery Prolongs Postoperative Hospital Length of Stay but Does Not Adversely Affect Outcomes at 30 Days.

OBJECTIVES

To evaluate the association between the timing of hip fracture surgery with postoperative length of stay and outcomes.

DESIGN

Retrospective review using the American College of Surgeons National Surgical Quality Improvement Program database.

SETTING

National inquiry database incorporating 140 academic and private medical centers.

PATIENTS

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.

INTERVENTION

Surgical management of hip fractures was performed at the discretion of participating surgeons.

OUTCOME MEASURE

Thirty-day outcomes including postoperative length of stay, readmission rates, reoperation rates, complications, and mortality rates.

RESULTS

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.

CONCLUSIONS

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.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.