Early surgery within 48 hours of admission for hip fracture did not improve 1-year mortality in Japan: a single-institution cohort study.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-05-21 DOI:10.1177/11207000241248836
Hiroki Iida, Yasuhiko Takegami, Yoshihito Sakai, Tsuyoshi Watanabe, Yusuke Osawa, Shiro Imagama
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引用次数: 0

Abstract

Introduction: Early surgery for hip fracture, within 48 hours of hospital admission, is effective in reducing mortality. However, the average preoperative waiting time for hip fractures in Japan is 4.5 days and the 1-year mortality rate after a hip fracture is 10% in Japan. This study aimed to investigate whether early surgery, within 48 hours, could reduce the 1-year mortality rate in patients with hip fractures in Japan.

Methods: This cohort study involved 402 consecutive patients with hip fractures who underwent surgical treatment between January 2013 and September 2019. The exclusion criteria were an age of <60 years and in-hospital injury. A total of 389 patients were included in this study. The patients were divided into two groups: those who underwent early surgery within 48 hours of admission (early group) and those who di not undergo early surgery (delayed group). We compared patient characteristics and treatment outcomes between the 2 groups.

Results: A comparison of patient characteristics revealed that the early group had lower hemoglobin levels (P=0.046), lower C-reactive protein levels (P = 0.031), lower numbers of patients with weekend hospitalization, lower numbers of patients with a history of using medications that may cause bleeding (P < 0.01), and who received general anaesthesia (P < 0.01). However, there were no significant differences with regard to the other variables between the 2 groups. A treatment outcome analysis showed that the early group had shorter waiting times for surgery (P < 0.01) and shorter stays in acute-care wards (P < 0.01). However there were no differences in the total hospital stay, Barthel index at discharge, home discharge rates, in-hospital mortality rates, and 1-year mortality.

Conclusion: Our findings indicate that early surgery did not reduce the 1-year mortality rate in older patients with hip fractures in Japan.

在日本,髋部骨折患者入院 48 小时内尽早手术并不能改善 1 年死亡率:一项单一机构队列研究。
简介入院 48 小时内尽早进行髋部骨折手术可有效降低死亡率。然而,日本髋部骨折患者术前平均等待时间为 4.5 天,髋部骨折后 1 年的死亡率为 10%。本研究旨在探讨在 48 小时内尽早手术是否能降低日本髋部骨折患者的 1 年死亡率:这项队列研究涉及 402 名在 2013 年 1 月至 2019 年 9 月期间接受手术治疗的连续髋部骨折患者。排除标准为年龄不超过 50 岁:对患者特征进行比较后发现,早期手术组患者的血红蛋白水平较低(P=0.046),C反应蛋白水平较低(P=0.031),周末住院的患者人数较少,有可能导致出血的药物使用史的患者人数较少(P P P P 结论:我们的研究结果表明,早期手术并不会对髋部骨折患者的健康造成影响:我们的研究结果表明,早期手术并未降低日本老年髋部骨折患者的 1 年死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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