Benjamin Hammond, Danielle Olson, Abhishek Ganta, Kenneth A Egol, Sanjit R Konda
{"title":"Hip Fracture Surgery Performed <24 Hours vs. >24 Hours (Next Calendar Day) After Emergency Department Presentation Yields Equivalent Outcomes.","authors":"Benjamin Hammond, Danielle Olson, Abhishek Ganta, Kenneth A Egol, Sanjit R Konda","doi":"10.5435/JAAOS-D-25-00799","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To compare outcomes of patients with geriatric hip fracture undergoing surgery <24 hours from emergency department (ED) arrival to those who underwent surgery >24 hours from arrival but within the next calendar day.</p><p><strong>Methods: </strong>A retrospective review of a single-institution hip fracture database (2014 to 2024) was performed. The study cohort was divided into two groups based on time from ED arrival to surgery start time: <24-hour surgery (<24h) and next calendar day surgery >24 hours from arrival (>24h [next calendar day]). Univariate analysis was performed to compare baseline health, injury factors, and outcomes. Multivariate linear and logistic regression analyses were performed to adjust for procedure type and risk profile.</p><p><strong>Results: </strong>There were 1,694 patients included in the study analysis, of whom 964 (56.91%) were <24h and 730 (43.09%) were >24h (next calendar day). The mean time to surgery for cohorts were <24h: 17.66 ± 5.05 vs. >24h (next calendar day): 28.78 ± 3.86 hours; P < 0.001. Univariate analysis revealed no differences between <24h and >24h (next calendar day) cohorts for in-hospital complication incidence (35.5% vs. 35.1%; P = 0.862), inpatient mortality (0.5% vs. 1.0%; P = 0.285), 30-/90-day readmission (5.6% vs. 6.2%; P = 0.625; 8.2% vs. 11.0%; P = 0.053), and 30-day/1-year mortality (2.4% vs. 2.3%; P = 0.939; 5.0% vs. 6.2%; P = 0.289). Length of stay (5.15 ± 3.15 vs. 5.58 ± 3.31; P = 0.006) and discharge location (36.4% home discharge vs. 31.0%; P = 0.019) favored the <24h cohort. After adjusting for baseline health with Score for Trauma Triage in the Geriatric and Middle-Aged and procedure type, only longer length of stay was found to be associated with the >24h (next calendar day) cohort (B = 0.407; P = 0.010).</p><p><strong>Conclusion: </strong>No notable differences were observed in key outcomes for patients undergoing <24 hours from ED arrival versus those who undergo surgery >24 hours after arrival but on the next calendar day. This study suggests that \"next day hip fracture surgery\" appears safe for patients with geriatric hip fracture.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1426-e1431"},"PeriodicalIF":2.8000,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Orthopaedic Surgeons","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5435/JAAOS-D-25-00799","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: To compare outcomes of patients with geriatric hip fracture undergoing surgery <24 hours from emergency department (ED) arrival to those who underwent surgery >24 hours from arrival but within the next calendar day.
Methods: A retrospective review of a single-institution hip fracture database (2014 to 2024) was performed. The study cohort was divided into two groups based on time from ED arrival to surgery start time: <24-hour surgery (<24h) and next calendar day surgery >24 hours from arrival (>24h [next calendar day]). Univariate analysis was performed to compare baseline health, injury factors, and outcomes. Multivariate linear and logistic regression analyses were performed to adjust for procedure type and risk profile.
Results: There were 1,694 patients included in the study analysis, of whom 964 (56.91%) were <24h and 730 (43.09%) were >24h (next calendar day). The mean time to surgery for cohorts were <24h: 17.66 ± 5.05 vs. >24h (next calendar day): 28.78 ± 3.86 hours; P < 0.001. Univariate analysis revealed no differences between <24h and >24h (next calendar day) cohorts for in-hospital complication incidence (35.5% vs. 35.1%; P = 0.862), inpatient mortality (0.5% vs. 1.0%; P = 0.285), 30-/90-day readmission (5.6% vs. 6.2%; P = 0.625; 8.2% vs. 11.0%; P = 0.053), and 30-day/1-year mortality (2.4% vs. 2.3%; P = 0.939; 5.0% vs. 6.2%; P = 0.289). Length of stay (5.15 ± 3.15 vs. 5.58 ± 3.31; P = 0.006) and discharge location (36.4% home discharge vs. 31.0%; P = 0.019) favored the <24h cohort. After adjusting for baseline health with Score for Trauma Triage in the Geriatric and Middle-Aged and procedure type, only longer length of stay was found to be associated with the >24h (next calendar day) cohort (B = 0.407; P = 0.010).
Conclusion: No notable differences were observed in key outcomes for patients undergoing <24 hours from ED arrival versus those who undergo surgery >24 hours after arrival but on the next calendar day. This study suggests that "next day hip fracture surgery" appears safe for patients with geriatric hip fracture.
前言：比较老年髋部骨折患者在到达后24小时至下一个日历日内接受手术的结果。方法：对2014年至2024年单机构髋部骨折数据库进行回顾性分析。研究队列根据到达ED到手术开始时间分为两组：到达ED后24小时（>24小时[下一个日历日]）。进行单变量分析，比较基线健康、损伤因素和结果。进行多变量线性和逻辑回归分析以调整手术类型和风险概况。结果：1694例患者纳入研究分析，其中964例（56.91%）为24h（下一个日历日）。队列平均手术时间为24小时（下一个日历日）：28.78±3.86小时；P < 0.001。单因素分析显示，24小时（下一个日历日）队列的住院并发症发生率（35.5% vs. 35.1%, P = 0.862）、住院死亡率（0.5% vs. 1.0%, P = 0.285）、30 /90天再入院率（5.6% vs. 6.2%, P = 0.625; 8.2% vs. 11.0%, P = 0.053）和30天/1年死亡率（2.4% vs. 2.3%, P = 0.939; 5.0% vs. 6.2%, P = 0.289）无差异。住院时间（5.15±3.15比5.58±3.31,P = 0.006）和出院地点（36.4%回家比31.0%,P = 0.019）倾向于24小时（下一个日历日）队列（B = 0.407, P = 0.010）。结论：患者在到达后24小时与下一个日历日的关键结局无显著差异。这项研究表明，“第二天髋部骨折手术”对老年髋部骨折患者是安全的。
期刊介绍：
The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues.
Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
