Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA.
J Orthop Trauma. 2023 Jun 1;37(6):270-275. doi: 10.1097/BOT.0000000000002568.
To explore the association between time to surgery (TTS) and postoperative complications in geriatric patients with acetabular fractures.
Retrospective cohort study.
Level I trauma center.
PATIENTS/PARTICIPANTS: 51 consecutive geriatric patients (60 years of age or older) who presented to a Level 1 trauma center for surgical fixation of an acetabular fracture between 2013 and 2020.
The primary and secondary outcomes were 30-day postoperative complications and length of hospital stay (LOS), respectively. TTS was determined by time between arrival to ED and time of surgery, with a threshold of 48 hours (early vs. delayed TTS group).
Nineteen patients (37.3%) had ≥1 postoperative complications. Patients in the delayed TTS group had 5× higher odds of developing ≥1 complications (odds ratio: 4.86, confidence interval: 1.48-15.96). There were no 30-day mortalities in either group. Patients in the delayed TTS group had an average LOS of 19 days compared with early TTS patients who had an average LOS of 12 days ( P = 0.040).
Geriatric patients with acetabular fractures with delayed TTS had increased postoperative complications and LOS. These data suggest that expedited care may have a similar protective effect in geriatric patients with acetabular fractures, as it does in the acute hip fracture population.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
探讨老年髋臼骨折患者手术时间（TTS）与术后并发症的关系。
回顾性队列研究。
一级创伤中心。
患者/参与者：2013 年至 2020 年间，51 例连续的老年患者（60 岁或以上）因髋臼骨折到一级创伤中心接受手术固定。
主要和次要结局分别为术后 30 天并发症和住院时间（LOS）。TTS 通过到达急诊室和手术时间之间的时间来确定，阈值为 48 小时（早期与延迟 TTS 组）。
19 例（37.3%）患者发生≥1 种术后并发症。延迟 TTS 组患者发生≥1 种并发症的可能性是早期 TTS 组的 5 倍（优势比：4.86，置信区间：1.48-15.96）。两组均无 30 天死亡病例。延迟 TTS 组患者的平均 LOS 为 19 天，而早期 TTS 患者的平均 LOS 为 12 天（P = 0.040）。
髋臼骨折延迟 TTS 的老年患者术后并发症和 LOS 增加。这些数据表明，在髋臼骨折的老年患者中，加速治疗可能与急性髋部骨折患者一样具有类似的保护作用。
治疗性 III 级。有关证据水平的完整说明，请参见作者说明。
