Performing early surgery on elderly hip fracture patients reduces the risk of death by 19%, found a study published in CMAJ (Canadian Medical Association Journal).
Hip fractures are associated with a mortality rate of 14 to 36% in the year following the fracture and can negatively affect a patient's independence and quality of life. Current guidelines recommend surgery within 24 hours of the break, although some physicians who favour delays believe it provides more time to prepare the patient and can decrease the risk of complications.
The researchers, from McMaster University and the University of Toronto, set out to determine the impact of early versus delayed surgery on death and postoperative complications. They looked at 16 observational studies with a total of 13, 478 patients aged 60 years and older. They found that surgery before 24 to 72 hours reduced the risk of death and may reduce the risk of postoperative pneumonia and pressure sores.
"Based on current evidence, surgery conducted before 24-72 hours is associated with reduced mortality and certain postoperative complications in elderly hip fracture patients," write Dr. Mohit Bhandari, McMaster University, with coauthors.
The authors recommend additional studies to better understand the effect of early surgery among elderly hip fracture patients.
- Nicole Simunovic, P. J. Devereaux, Sheila Sprague, Gordon H. Guyatt, Emil Schemitsch, Justin Debeer, Mohit Bhandari. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. Canadian Medical Association Journal, 2010; DOI: 10.1503/cmaj.092220
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