Time-to-Incision for Hip Fractures in a Canadian Level-1 Trauma Centre: Are We Respecting the Guidelines?
Background Surgical intervention within 48 hours is recommended for hip fractures in the elderly in order to reduce post-operative complications and lower mortality rates. The purpose of this retrospective study is to explore the causes of surgical delays for acute geriatric hip fractures. Methods T...
| Publicado en: | Canadian Geriatrics Journal Vol. 25; no. 1; pp. 57 - 66 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Canadian Geriatrics Society
Mar2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155545253&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155545253 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19258348 EV2Z jtl: Canadian Geriatrics Journal issn: 19258348 maglogo: N pubinfo: dt: Mar2022 vid: 25 iid: 1 pid: 76420 pub: Canadian Geriatrics Society place: Markham, Ontario artinfo: ui: 155545253 155545253 155545253 10.5770/cgj.25.529 155545253 ppf: 57 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Time-to-Incision for Hip Fractures in a Canadian Level-1 Trauma Centre: Are We Respecting the Guidelines? aug: au: Denis, Antoine Reindl, JulienRudolf Berry, Gregory K. Harvey, Edward J. Bernstein, Mitchell affil: Faculty of Medicine, McGill University, Montreal, QC sug: subj: Treatment Delay Risk Factors Acute Disease Surgery Trauma Centers Canada Hip Fractures Surgery Human Male Female Canada Aged Retrospective Design Prospective Studies Electronic Health Records Fracture Fixation Benchmarking Descriptive Statistics Anticoagulants Administration and Dosage Time Factors Patient Discharge Waiting Lists Length of Stay Clinical Assessment Tools Aged: 65+ years Male Female ab: Background Surgical intervention within 48 hours is recommended for hip fractures in the elderly in order to reduce post-operative complications and lower mortality rates. The purpose of this retrospective study is to explore the causes of surgical delays for acute geriatric hip fractures. Methods This is a retrospective cohort study involving a total of 109 consecutive geriatric patients who sustained proximal femur fractures ("hip fractures"), who subsequently underwent de- finitive fixation. Clinical, demographic, and direct costing data were extracted via a modern system and electronic medical records on a centralized data warehouse. Surgical delays and length of stay were analyzed according to clinical variables. Results The established benchmark of a time-to-surgery of less than 48 hours was respected for 63 (57.8%) patients. Patients on oral anticoagulant (ACO) waited significantly longer, on average 58 hours compared to 44 for non-anticoagulated patients (p = .007). Patients with higher ASA scores waited significantly longer (p = .0018). More importantly, patients treated within 48 hours were discharged significantly earlier, on average after 10 days compared to 16 days for patients who waited more than 48 hours before receiving surgical treatment (p = .003), regardless of the pre-operative waiting time. Conclusion Fewer than 60% of patients received surgery within the 48- hour benchmark after being admitted for an acute hip fracture in a Level-1 trauma centre. Patients with more comorbidities waited longer and stayed longer in the hospital after surgery. Implementing strategic, evidence-based changes should be done using this data to improve care of this vulnerable population. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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