BMC Surgery最新文献

{"title":"Outcomes of gastrectomy in octogenarians and nonagenarians: a comparative analysis in the era of minimally invasive surgery.","authors":"Kenjiro Ishii, Yusuke Akimoto, Osahiko Hagiwara, Toshiyuki Enomoto, Takaharu Kiribayashi, Koji Asai, Takuya Nagata, Manabu Watanabe, Yoshihisa Saida","doi":"10.1186/s12893-025-03156-5","DOIUrl":"10.1186/s12893-025-03156-5","url":null,"abstract":"<p><strong>Background: </strong>As the population of Japan continues to age rapidly, an increasing number of patients aged ≥ 80 years are undergoing surgery for gastric cancer. Although minimally invasive techniques have improved surgical safety, operative risks in the super-elderly population (≥ 85 years) remain a significant concern.</p><p><strong>Methods: </strong>This retrospective, single-center study analyzed 72 patients aged ≥ 80 years who underwent gastrectomy for gastric cancer at our hospital between January 2014 and August 2024. Patients were stratified into two groups: the super-elderly group (≥ 85 years, n = 26) and the younger-elderly group (80-84 years, n = 46). Clinical characteristics, perioperative outcomes, and postoperative complications were compared between the two groups. A p-value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age was 83.7 (range: 80-93) years. Comorbidities were common, particularly cardiovascular disease (19.4%) and diabetes mellitus (27.8%). Compared with the younger-elderly group, the super-elderly group had a longer preoperative hospital stay (5.8 vs. 4.5 days) but a shorter overall hospital stay (14.3 vs. 21.1 days). Minimally invasive surgery was less frequently performed in the super-elderly group (42.3% vs. 56.5%). Postoperative complications of Clavien-Dindo grade ≥ 2 occurred in 40.3% of all patients, with a lower incidence in the super-elderly group (34.6% vs. 43.5%). Mortality from non-cancer-related causes did not differ significantly between the groups.</p><p><strong>Conclusions: </strong>With appropriate preoperative optimization, gastrectomy can be performed safely in patients aged ≥ 85 years. Individualized treatment strategies that account for comorbidities are essential for achieving favorable outcomes in this expanding population.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"407"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing surgical management and outcomes of colonic trauma: a prospective observational study at three hospitals in Sana'a City, Yemen.","authors":"Ali Lotf Al-Amy, Mohaned Yahia Al-Ajaly, Haitham Mohammed Jowah","doi":"10.1186/s12893-025-03159-2","DOIUrl":"10.1186/s12893-025-03159-2","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"406"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total knee arthroplasty for ankylosed knees in the extended position with hemophilia: a medium- and long-term single-center experience.","authors":"Zhongyi Zhang, Yi Tang, Zhaokai Jin, Lei Chen, Xinyu Hu, Yichen Gong, Shineng Lin, Guoqian Chen, Shuaijie Lv, Peijian Tong","doi":"10.1186/s12893-025-03102-5","DOIUrl":"10.1186/s12893-025-03102-5","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is one of the curative methods for patients with end-stage ankylosed knees. However, the existing methods are difficult to enable patients with hemophilic ankylosed knees to recover good functional activities.</p><p><strong>Methods: </strong>Between January 2008 and December 2021, 22 male patients with ankylosed knees in the extended position due to hemophilia underwent TKA. The average age of the patients was 41.3 years (range, 19 to 52 years), and the average hospital stay was 33.4 days (range, 14 to 50 days). TKA was performed using quadriceps tendon Z-lengthening plasty, staged osteotomy, and comprehensive soft-tissue release. A variety of methods were used to evaluate the postoperative clinical outcomes and complications, including range of motion (ROM) assessment, Visual Analogue Scale (VAS), Knee Society Score (KSS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).</p><p><strong>Results: </strong>At the last follow-up, the average KSS increased from 75.14 ± 34.63 before surgery to 148.41 ± 27.74 (P < 0.001), the ROM increased from 0 to 86.14 ± 24.69 (P < 0.001), the WOMAC score changed from 28.05 ± 11.20 before surgery to 10.82 ± 11.00 (P < 0.001), and the average VAS score decreased from 2.86 ± 1.86 to 0.73 ± 1.20 (P < 0.001).</p><p><strong>Conclusion: </strong>Although the recovery of range of motion is lower than normal and there is a relatively high incidence of complications, TKA can still significantly improve the flexion and extension functions, mobility, and quality of life of patients with ankylosed knees.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"405"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the United States global surgery program landscape by website analysis.","authors":"Lauren E Cox, Cassandra M D'Amico, Shriya Bhoothapuri, Joseph A Q Karam, Rachel W Davis, Mike M Mallah","doi":"10.1186/s12893-025-02979-6","DOIUrl":"10.1186/s12893-025-02979-6","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, since the 2015 Lancet Commission on Global Surgery (LCoGS) highlighted the global burden of disease attributable to a lack of safe surgical care, medical degree-granting institutions across the United States (US) have worked to increase engagement in global surgery. The research team aimed to analyze the current landscape and provide an overview of all US-based global surgery programs. It was predicted that most medical institutions in the US would not have established programs. For those with global surgery programs, their mission statements and demonstrated output were classified according to a list of five domains, including bidirectionality, education, partnerships, research, and service. These domains were generated from the priorities outlined by the LCoGS 2030 objectives as there is no universally accepted gold standard for quality evaluation in global surgery education. The team hypothesized that mission statements for existing programs would meet a majority, but not all, of the five domains, and that programs would demonstrate less output than their projected goals.</p><p><strong>Methods: </strong>The team conducted a qualitative analysis of all global surgery programmatic offerings across the US. A list of terms was established to analyze the websites published for each US allopathic (MD) and osteopathic (DO) program. An Excel matrix was produced that outlined all desired information. The domains were used to organize and classify the collected data.</p><p><strong>Results: </strong>Out of 194 US MD- and DO- granting institutions, 39 had global surgery programs. Twenty-five programs had missions that addressed three to four of the domains and 12 programs projected pursuit of all five domains. Of the 12 programs that projected this mission to meet all five objectives, six demonstrated tangible output in all five areas. Bidirectionality was the most common domain not addressed by programs in either their mission statement or output.</p><p><strong>Conclusions: </strong>Global surgery is a nascent field, and as predicted, the majority of medical institutions do not have a global surgery program. Furthermore, institutions with programs and well-defined missions did meet a majority of the five domains. Contrary to the team's prediction, most existing programs demonstrated equal or greater output than their expressed goals.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"404"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of surgical precision and safety in oncoplastic breast-conserving surgery for breast cancer under the guidance of imaging.","authors":"Han Qiu, Qian Liu, Jing Tian","doi":"10.1186/s12893-025-03130-1","DOIUrl":"10.1186/s12893-025-03130-1","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast-conserving surgery (OBCS) has become an essential component of breast cancer treatment. Imaging guidance in breast surgery has the potential to enhance surgical precision. Despite increasing recognition, a comprehensive evaluation of its specific impact on OBCS for breast cancer is needed. This study aims to evaluate the impact of the application of imaging guidance in OBCS on the accuracy and safety of breast cancer surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included patients treated for breast cancer, divided into the OBCS group (Group A, n = 65) and the imaging-guided OBCS group (Group B, n = 69). Demographics, perioperative parameters, surgical margins, and postoperative complications of the study population were evaluated to assess the impact of imaging guidance on OBCS. Pearson correlation analysis was conducted to explore the relationship between various indicators and imaging-guided OBCS.</p><p><strong>Results: </strong>A total of 134 patients were included. Compared to Group A, Group B showed significant reductions in operation time, intraoperative blood loss, excised breast weight, and length of stay. Additionally, Group B had narrower surgical margins and fewer postoperative complications, including hematoma, wound dehiscence, subcutaneous bleeding, and fluid accumulation. Correlation analysis revealed a strong negative association between imaging-guided OBCS and various surgical indices, highlighting the potential benefits of imaging guidance in enhancing surgical precision and patient outcomes.</p><p><strong>Conclusion: </strong>The findings of this study support the potential of imaging-guided OBCS to enhance surgical precision and safety in breast cancer management, offering benefits across multiple aspects of surgical care and patient prognosis.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"403"},"PeriodicalIF":1.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative lactate levels as prognostic indicators in patients undergoing early excision and grafting for extensive burns.","authors":"Xinyi Li, Xiaodan Dong, Jianhua Luo, Lin Wang, Yang Cao, Yan Zhang, Bing Liang","doi":"10.1186/s12893-025-03133-y","DOIUrl":"10.1186/s12893-025-03133-y","url":null,"abstract":"<p><strong>Background: </strong>Elevated lactate levels are reliable biomarkers of tissue hypoperfusion and metabolic stress. However, their prognostic significance in extensive burn patients undergoing early excision and grafting (EEG) remains unclear. This study aimed to evaluate the prognostic value of perioperative lactate levels in predicting clinical deterioration following EEG in patients with extensive burns.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult burn patients with ≥ 50% total burn surface area (TBSA) or ≥ 20% full-thickness burns treated between March 2021 and September 2023 were included. Patients were categorized into Deterioration and Non-Deterioration groups based on changes in Sequential Organ Failure Assessment (SOFA) scores. Statistical analyses included univariate and multivariate logistic regression, as well as receiver-operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Of 82 patients, 37.8% were classified into the Deterioration Group. Compared with the Non-Deterioration Group, these patients presented with a significantly higher burn index (BI), larger surgical area, and greater intraoperative blood transfusion volumes. Temporal trends in lactate levels appeared to differ between groups: lactate levels peaked on POD1 and returned to baseline by postoperative Day 3(POD3) in the Non-Deterioration Group, whereas they remained persistently elevated in the Deterioration Group. Among all perioperative time points, lactate levels on POD3 were significantly higher in the Deterioration Group (2.88 ± 0.65 mmol/L vs. 2.27 ± 0.68 mmol/L, p < 0.001) and were independently associated with clinical deterioration clinical deterioration (OR 2.97, 95% CI 1.18-8.71, p = 0.031). POD3 lactate levels demonstrated the highest discriminatory performance for identifying postoperative deterioration (AUC = 0.761, 95% CI 0.656-0.866).</p><p><strong>Conclusions: </strong>Among perioperative lactate levels in patients undergoing EEG for extensive burns, POD3 lactate levels were significantly associated with clinical deterioration and may serve as a useful marker to guide early risk assessment and supportive interventions.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"402"},"PeriodicalIF":1.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of chest radiograph and surface measurement to predict cavoatrial junction position of totally implantable venous-access port.","authors":"Meng-Ling Li, Di-Tian Zhang, Peng-Fei Li","doi":"10.1186/s12893-025-03150-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03150-x","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting cavoatrial junction (CAJ) position is important for totally implantable venous-access port (TIVAP) application, which could reduce complications.</p><p><strong>Methods: </strong>Clinical information of 117 breast cancer (BRCA) patients who underwent TIVAP implantation was collected. The length of the implanted catheter was determined by a chest radiograph method in the test group, as follows: total catheter insertion length was L, and the distance from the pre-puncture point to the right sternoclavicular joint was measured as L1; the distance from the right sternoclavicular joint to 1.5 vertebral bodies under the trachea carina in the chest radiograph was measured as L2; the preset catheter length was L = L1 + L2. The length of the implanted catheter was determined by a surface measurement method in the control group, as follows: total length of catheter insertion was L; the distance from the pre-puncture point to the right sternoclavicular joint was measured as L1; the distance from the third anterior intercostal space of the right sternoclavicular joint was measured on the body surface as L2; the preset catheter length was L = L1 + L2. CAJ positioning rate and complication rate were compared between the two method groups. Logistic regression analysis, receiver operating characteristic, and decision curve analysis were performed to evaluate the predictive value of the chest radiograph.</p><p><strong>Results: </strong>For BRCA patients, the chest radiograph was exhibited more accurately in predicting CAJ position. Subgroup analysis indicated a remarkably higher CAJ position rate in the chest radiograph method group regardless of age, while no significant difference between the two measurement groups for patients with BMI > 24.9 kg/m² was observed.</p><p><strong>Conclusion: </strong>The chest radiograph method could more effectively predict the CAJ position than the surface measurement in the overall cohort. However, subgroup analysis revealed that this advantage was not statistically significant in patients with BMI > 24.9 kg/m², suggesting reduced efficacy in high-BMI populations.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"400"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical safety study of laparoscopic common bile duct exploration and primary suture in elderly patients: a new strategy for the treatment of stones.","authors":"Hai-Wen Ye, Fei Liu, Dai-Jiao Gu, Jie Liao, Rong-Sen Huang, Jun-Jiang Pan","doi":"10.1186/s12893-025-03146-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03146-7","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic common bile duct exploration and primary suture (LBEPS) offers advantages such as minimal invasion, shorter operative time, and faster postoperative recovery in the treatment of common bile duct stones.However, its safety in elderly patients remains controversial.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 128 patients with common bile duct stones who underwent LBEPS treatment in our hospital from December 2018 to March 2025.The patients were divided into an elderly group (≥ 65years, n = 55) and a non-elderly group (< 65years, n = 73) based on age.Baseline characteristics, operative time, postoperative complications, recurrence rate, and other indicators were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics, such as sex, body mass index(BMI), or stone diameter, between the two groups (P > 0.05). The diameter of the common bile duct was significantly larger in the elderly group compared to the non-elderly group (P < 0.05). There were no significant differences in alanine aminotransferase (ALT), aspartate aminotransferase(AST), total bilirubi (TB), direct bilirubin (DB), white blood cells (WBC), haemoglobin (HGB), or platelet (PLT) levels between the two groups before and after surgery(P > 0.05). However, the postoperative drainage time and total hospital stay were longer in the elderly group (P < 0.05). The presence of hepatitis B was identified as an independent risk factor for complications after LBEPS.</p><p><strong>Conclusion: </strong>The clinical application of LBEPS in elderly patients with common bile duct stones is safe and feasible.Elderly patients require a longer preoperative length of stay compared to non-elderly patients.Patients with common bile duct stones and concomitant hepatitis B are more prone to complications after LBEPS.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"401"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to normal activity after abdominal surgery: a pre-planned secondary analysis of a randomised controlled trial across seven low- and middle-income countries.","authors":"Omar Omar, Sivesh Kathir Kamarajah","doi":"10.1186/s12893-025-03079-1","DOIUrl":"https://doi.org/10.1186/s12893-025-03079-1","url":null,"abstract":"<p><strong>Background: </strong>Recovery after major surgery is a key priority identified by patients, communities and policymakers in low- and middle-income countries (LMICs), with important societal and financial implications. With global burden of surgical diseases rising, little is known about how well patients return to normal activities after surgery in these settings. This study aimed to describe patterns of return to normal activity after major abdominal surgery and identify associated factors in LMICs.</p><p><strong>Methods: </strong>This was a pre-planned analysis of a cluster-randomised randomised trial testing routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection in seven LMICs (India, Mexico, Rwanda, Benin, South Africa, Nigeria, Ghana). 961 patients were excluded because of incomplete missing primary outcome. The primary outcome measure was a patients self-reported full return to their normal activities at 30 days after surgery. Factors associated with return to normal activities within 30-days of surgery was explored using a Bayesian mixed-effects logistic regression model. Sensitivity analyses were performed accounting for missing data.</p><p><strong>Results: </strong>12,340 patients across 81 centres were included. Overall, 65.3% (8064/12340) patients had returned to normal activity by 30-days after surgery. Patients undergoing surgery for benign than cancer surgery (67.0% vs. 59.7%), minor compared to major surgery (71.0% vs. 63.5%), and non-midline compared to midline (74.9% vs. 58.7%) had higher rates of return to normal activities within 30-days from abdominal surgery. In an adjusted model, factors associated with return to normal activities are benign surgery (OR: 0.61, 95% CI: 0.53-0.71), minor surgery (OR: 0.56, 95% CI: 0.49-0.64), and non-midline operations (OR: 1.57, 95% CI: 1.41-1.75). When accounting for missing data, consistent findings were observed.</p><p><strong>Conclusions: </strong>With rising need for surgical care and non-communicable disease globally, this study highlights the groups of patients at critical need for improving return to normal activity or recovery after surgery in LMICs. Improving access and implementation of rehabilitation pathways, aligned to the World Health Organisation, may be crucial to improve financial risk protection to patient and reduce productivity loss to the economy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"399"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waiting time and 30-day mortality association in elderly patients having hip fracture surgery.","authors":"Min-Zhe Xu, Ke Lu, Yao-Wei Ye, Si-Ming Xu, Qin Shi, Ya-Qin Gong, Chong Li","doi":"10.1186/s12893-025-03140-z","DOIUrl":"https://doi.org/10.1186/s12893-025-03140-z","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aims to investigate the possible independent association between 30-day mortality rate and the length of waiting time in older people who underwent underwent surgery for hip fractures.</p><p><strong>Methods: </strong>This is a retrospective cohort study. Data were collected from 818 individuals aged 65 years and above who underwent surgery for hip fractures between January 2017 and July 2022 at the Affiliated Kunshan Hospital of Jiangsu University. The exposure variable was the length of waiting time, while the outcome variable was the 30-day mortality rate following hip fracture surgery. Potential covariates were analyzed including month of admission to hospital, week of admission to hospital, hip fracture category, body mass index (BMI), American Society of Anesthesiologists (ASA) score, age, surgery, gender, operation time and laboratory data. The association was finally analyzed using logistic regression models.</p><p><strong>Results: </strong>Our findings revealed a positive association between 30-day mortality rate and waiting time in older people who underwent surgery for hip fractures. The obtained results showed an increase in the 30-day mortality by 13.6% (OR, 1.136; 95% CI, 1.027 to 1.256; P-value = 0.0136) when there was an addition of 10 h of waiting time after the adjustment of the covariates. The results showed a nonlinear relationship of the 30-day mortality and waiting time, while the inflection point for the waiting time in the smoothed curve was observed at 42. 428 h. Furthermore, when waiting time was < 42. 428 h, we did not detect an increase in the probability of 30-day mortality. However, a waiting time of more than 42. 428 h may increase the risk of 30-day mortality.</p><p><strong>Conclusions: </strong>Our study provides evidence of a clear positive association between waiting time before hip fracture surgery and 30-day mortality risk in older individuals. The waiting time of 42. 428 h may represent a threshold for higher risk of mortality.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"397"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}