Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis
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Open Access
- 17 September 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in Scientific Reports
- Vol. 8 (1), 1-15
- https://doi.org/10.1038/s41598-018-32098-7
Abstract
We aimed to assess the impact of timing of surgery in elderly patients with acute hip fracture on morbidity and mortality. We systematically searched MEDLINE, the Cochrane Library, Embase, PubMed, and trial registries from 01/1997 to 05/2017, as well as reference lists of relevant reviews, archives of orthopaedic conferences, and contacted experts. Eligible studies had to be randomised controlled trials (RCTs) or prospective cohort studies, including patients 60 years or older with acute hip fracture. Two authors independently assessed study eligibility, abstracted data, and critically appraised study quality. We conducted meta-analyses using the generic inverse variance model. We included 28 prospective observational studies reporting data of 31,242 patients. Patients operated on within 48 hours had a 20% lower risk of dying within 12 months (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.66–0.97). No statistical significant different mortality risk was observed when comparing patients operated on within or after 24 hours (RR 0.82, 95% CI 0.67–1.01). Adjusted data demonstrated fewer complications (8% vs. 17%) in patients who had early surgery, and increasing risk for pressure ulcers with increased time of delay in another study. Early hip surgery within 48 hours was associated with lower mortality risk and fewer perioperative complications.Keywords
This publication has 66 references indexed in Scilit:
- Older People With Hip Fracture and IADL Disability Require Earlier SurgeryThe Journals of Gerontology: Series A, 2012
- A systematic review of hip fracture incidence and probability of fracture worldwideOsteoporosis International, 2012
- Mortality and cause of death in hip fracture patients aged 65 or older - a population-based studyBMC Musculoskeletal Disorders, 2011
- Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysisCMAJ : Canadian Medical Association Journal, 2010
- The 1-Year Mortality of Patients Treated in a Hip Fracture Program for EldersGeriatric Orthopaedic Surgery & Rehabilitation, 2010
- Updated fracture incidence rates for the US version of FRAX®Osteoporosis International, 2009
- The effect of time-to-surgery on outcome in elderly patients with proximal femoral fracturesBMC Musculoskeletal Disorders, 2008
- Hip fractureBMJ, 2006
- Measuring inconsistency in meta-analysesBMJ, 2003
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002