Sung Aejin, Kim Dong Hoon, Kim Dong-Hee, Jeong Jin Hee
Department of Emergency Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Gyeongsang Institute of Medical Sciences, Gyeongsang National University College of Medicine, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Sci Rep. 2025 Jul 2;15(1):22682. doi: 10.1038/s41598-025-08913-3.
Hip fractures are a significant health concern, increasingly common among the elderly. Surgical intervention is crucial and recommended within 48 h of presentation. Many patients with hip fractures present to the emergency department (ED), but the impact of ED-related factors remains unclear. This study investigated ED-related factors affecting surgical delay in hip fracture patients. This retrospective observational study evaluated patients aged ≥ 60 years with hip fractures who presented to a tertiary care university hospital ED between January 2017 and December 2022. Demographic and clinical variables, including ED-related factors such as length of stay and occupancy, were recorded. Outcomes were delayed surgery (i.e., performed after 48 h). Among 434 patients, 209 underwent early surgery and 225 delayed surgery. Univariate analyses revealed significant associations between time to surgery and comorbidities, presentation on the day before holidays, prolonged ED stay, surgery type, international normalized ratio, and albumin levels. In multivariable analysis, ischemic heart disease, presentation on the day before holidays, prolonged ED stay, surgery type, and albumin level ≤ 3.8 g/dL were significantly associated with delayed surgery. In conclusion, delayed surgery is associated with ischemic heart disease, pre-holiday presentation, prolonged ED stay, surgery type, and albumin ≤ 3.8 g/dL.
髋部骨折是一个重大的健康问题，在老年人中越来越常见。手术干预至关重要，建议在就诊后48小时内进行。许多髋部骨折患者会前往急诊科（ED）就诊，但与急诊科相关的因素的影响仍不明确。本研究调查了影响髋部骨折患者手术延迟的急诊科相关因素。这项回顾性观察性研究评估了2017年1月至2022年12月期间在一家三级护理大学医院急诊科就诊的年龄≥60岁的髋部骨折患者。记录了人口统计学和临床变量，包括与急诊科相关的因素，如住院时间和床位占用情况。结果为手术延迟（即48小时后进行）。在434例患者中，209例接受了早期手术，225例延迟手术。单因素分析显示，手术时间与合并症、节假日前夕就诊、急诊科住院时间延长、手术类型、国际标准化比值和白蛋白水平之间存在显著关联。在多变量分析中，缺血性心脏病、节假日前夕就诊、急诊科住院时间延长、手术类型和白蛋白水平≤3.8g/dL与手术延迟显著相关。总之，手术延迟与缺血性心脏病、节前就诊、急诊科住院时间延长、手术类型和白蛋白≤3.8g/dL有关。
